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Declines in late-life disability: The role of early- and mid-life factors

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  • Freedman, Vicki A.
  • Martin, Linda G.
  • Schoeni, Robert F.
  • Cornman, Jennifer C.

Abstract

Investigations into the reasons for declines in late-life disability have largely focused on the role of contemporaneous factors. Adopting a life-course perspective as a backdrop, in this paper we ask whether there also has been a role for selected early- and mid-life factors in the decline, and if so whether these factors have been operating through changes in the risks of disability onset or recovery. Drawing on five waves from 1995 to 2004 of the U.S. Health and Retirement Study, we found for the 75 years and older population in the United States that the prevalence of difficulty with activities of daily living (ADL) declined from 30.2% in 1995 to 26.0% in 2004, whereas the trend in difficulty with instrumental activities of daily living (IADL) was flat. Onset of ADL limitations also was reduced during this period while recovery increased. Changes in the educational composition of the older population were linked to declines in the prevalence of ADL limitations, but there were also modest contributions of changes in mother's education, self-rated childhood health, and lifetime occupation. Declines in late-life vision impairments and increases in wealth also contributed substantially to the downward trend, and had chronic conditions not increased, it would have been even larger. Reductions in the onset of ADL limitations were partly driven by changes in educational attainment of respondents and their mothers and, in late-life, better vision and wealth. In contrast, the recovery trend was not accounted for by changes in early- or mid-life factors. We conclude that early- and mid-life factors have contributed along with late-life factors to U.S. late-life disability trends mainly through their influence on the onset of, rather than recovery from, limitations.

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  • Freedman, Vicki A. & Martin, Linda G. & Schoeni, Robert F. & Cornman, Jennifer C., 2008. "Declines in late-life disability: The role of early- and mid-life factors," Social Science & Medicine, Elsevier, vol. 66(7), pages 1588-1602, April.
    • Handle: RePEc:eee:socmed:v:66:y:2008:i:7:p:1588-1602
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    11. Lorenti, Angelo & Dudel, Christian & Hale, Jo Mhairi & Myrskylä, Mikko, 2020. "Working and disability expectancies at older ages: the role of childhood circumstances and education," LSE Research Online Documents on Economics 106194, London School of Economics and Political Science, LSE Library.
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    15. Zachary Zimmer & Heidi Hanson & Ken Smith, 2016. "Childhood socioeconomic status, adult socioeconomic status, and old-age health trajectories," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 34(10), pages 285-320.
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    17. Samir KC & Harold Lentzner, 2010. "The effect of education on adult mortality and disability: a global perspective," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 8(1), pages 201-235.
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    19. Eggink, Evelien & Ras, Michiel & Woittiez, Isolde, 2017. "Dutch long-term care use in an ageing population," The Journal of the Economics of Ageing, Elsevier, vol. 9(C), pages 63-70.

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