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Explaining Disability Trends in the U.S. Elderly and Near‐Elderly Population
Author(s) -
Chen Yiqun,
Sloan Frank A.
Publication year - 2015
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12284
Subject(s) - medicine , gerontology , obesity , chronic disease , activities of daily living , educational attainment , demography , disease , physical therapy , family medicine , pathology , sociology , economics , economic growth
Objective To examine disability trends among U.S. near‐elderly and elderly persons and explain observed trends. Data Source 1996–2010 waves of the Health and Retirement Study. Study Design We first examined trends in Activities of Daily Living and Instrumental Activities of Daily Living limitations, and large muscle, mobility, gross motor, and fine motor indexes. Then we used decomposition analysis to estimate contributions of changes in sociodemographic composition, self‐reported chronic disease prevalence and health behaviors, and changes in disabling effects of these factors to disability changes between 1996 and 2010. Principal Findings Disability generally increased or was unchanged. Increased trends were more apparent for near‐elderly than elderly persons. Sociodemographic shifts tended to reduce disability, but their favorable effects were largely offset by increased self‐reported chronic disease prevalence. Changes in smoking and heavy drinking prevalence had relatively minor effects on disability trends. Increased obesity rates generated sizable effects on lower‐body functioning changes. Disabling effects of self‐reported chronic diseases often declined, and educational attainment became a stronger influence in preventing disability. Conclusions Such unfavorable trends as increased chronic disease prevalence and higher obesity rates offset or outweighed the favorable effects with the result that disability remained unchanged or increased.