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

TitleDeclines in late-life disability: the role of early- and mid-life factors.
Publication TypeJournal Article
Year of Publication2008
AuthorsFreedman, VA, Martin, LG, Schoeni, RF, Cornman, JC
JournalSoc Sci Med
Date Published2008 Apr
ISSN Number0277-9536
Call Numbernewpubs20080411_SocSciMed.pdf
KeywordsActivities of Daily Living, Aged, Aged, 80 and over, Aging, Chronic disease, Cross-Sectional Studies, Disabled Persons, Female, Frail Elderly, Health Behavior, Health Status, Health Surveys, Humans, Life Style, Logistic Models, Male, Morbidity, Population Surveillance, Socioeconomic factors, United States

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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Alternate JournalSoc Sci Med
Citation Key7214
PubMed ID18222580
PubMed Central IDPMC2408829
Grant ListR01 AG021516 / AG / NIA NIH HHS / United States
R01 AG 021516 / AG / NIA NIH HHS / United States
R24 HD041028 / HD / NICHD NIH HHS / United States
R01 AG021516-03 / AG / NIA NIH HHS / United States
R01 AG021516-04 / AG / NIA NIH HHS / United States