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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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    7. Nicolas Sirven, 2012. "On the Socio-Economic Determinants of Frailty: Findings from Panel and Retrospective Data from SHARE," Working Papers DT52, IRDES institut for research and information in health economics, revised Dec 2012.
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    17. Linda G. Martin & Zachary Zimmer & Jinkook Lee, 2017. "Foundations of Activity of Daily Living Trajectories of Older Americans," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 72(1), pages 129-139.
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