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Clinical Pathways to Disability

In: Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly

  • Mary Beth Landrum
  • Kate A. Stewart
  • David M. Cutler

This paper examines the pathways by which individuals transition from healthy to disabled. Because of the high prevalence and costs associated with disability, understanding these pathways is critical to developing interventions to prevent or minimize disability. We compare two estimates of disabling conditions: those observed in medical claims and conditions indicated by the disabled individual. A small number of conditions explain about half of incident disability: arthritis, infectious disease, dementia, heart failure, diabetes, and stroke. These conditions show up in medical claims and self reports. A large number of elderly also attribute disability to old age and various symptoms. Because so many of the most disabling conditions do not have clear medical treatments, the outlook for major reductions in disability might be limited.

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This chapter was published in:
  • David M. Cutler & David A. Wise, 2009. "Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly," NBER Books, National Bureau of Economic Research, Inc, number cutl08-1, December.
  • This item is provided by National Bureau of Economic Research, Inc in its series NBER Chapters with number 11113.
    Handle: RePEc:nbr:nberch:11113
    Contact details of provider: Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
    Phone: 617-868-3900
    Web page: http://www.nber.org
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    1. Robert F. Schoeni & Vicki A. Freedman & Robert B. Wallace, 2001. "Persistent, Consistent, Widespread, and Robust? Another Look at Recent Trends in Old-Age Disability," Journals of Gerontology: Series B, Gerontological Society of America, vol. 56(4), pages S206-S218.
    2. Lamb, Vicki L., 1996. "A cross-national study of quality of life factors associated with patterns of elderly disablement," Social Science & Medicine, Elsevier, vol. 42(3), pages 363-377, February.
    3. Timothy A. Waidmann & Korbin Liu, 2000. "Disability Trends Among Elderly Persons and Implications for the Future," Journals of Gerontology: Series B, Gerontological Society of America, vol. 55(5), pages S298-S307.
    4. Darius Lakdawalla & Dana Goldman & Jay Bhattacharya, 2001. "Are the Young Becoming More Disabled?," NBER Working Papers 8247, National Bureau of Economic Research, Inc.
    5. Verbrugge, Lois M. & Jette, Alan M., 1994. "The disablement process," Social Science & Medicine, Elsevier, vol. 38(1), pages 1-14, January.
    6. David M. Cutler, 2005. "Intensive Medical Technology and the Reduction in Disability," NBER Chapters, in: Analyses in the Economics of Aging, pages 161-184 National Bureau of Economic Research, Inc.
    7. Vicki Freedman & Eileen Crimmins & Robert Schoeni & Brenda Spillman & Hakan Aykan & Ellen Kramarow & Kenneth Land & James Lubitz & Kenneth Manton & Linda Martin & Diane Shinberg & Timothy Waidmann, 2004. "Resolving inconsistencies in trends in old-age disability: Report from a technical working group," Demography, Springer, vol. 41(3), pages 417-441, August.
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