Observing the Onset of Disability in Older Adults

One of the greatest threats to the abilityof older adults to live independently is the onset of disability in activities adults perform in their dailylives, such as dressing, eating, toileting, managing one s money, preparing meals and so on. This article examines the onset of disabilityin older adult Americans using three waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (1993, 1995, 1998; n 4228). We use medical/demographic factors (arthritis, heart disease, diabetes; age, gender, race/ethnicity, wealth), baseline characteristics (affect, cognition, health behaviors, medical insurance), and time-varying covariates (changes in chronic conditions and baseline characteristics) to predict the onset of activities of dailyliving (ADLs) and instrumental activities of dailyliving (IADLs) disability, individuallyand in the aggregate, over time. We find the onset of ADL and IADL disabilityis a complex process, suggesting important roles for medical, demographic, social, psychological, and behavioral triggers, specifically negative affect, higher bodyweight, and bythe lack of vigorous exercise. We also find that individual ADL and IADL impairments are predicted bya varietyof different factors, suggesting that summarymeasures of disability maybe masking a wealth of potentiallyuseful interventions. In general, public health efforts in the area of controlling obesity and treating depressive symptoms should be supported.

Disability/Disability/ADL and IADL Impairments

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