TY - JOUR T1 - Disability Trajectories at the End of Life: A "Countdown" Model. JF - J Gerontol B Psychol Sci Soc Sci Y1 - 2015 A1 - Douglas A. Wolf A1 - Vicki A Freedman A1 - Jan I Ondrich A1 - Christopher L Seplaki A1 - Brenda C Spillman KW - Aged KW - Aged, 80 and over KW - Aging KW - Death KW - Disabled Persons KW - Female KW - Humans KW - Male KW - Time Factors KW - United States AB -

OBJECTIVES: Studies of late-life disablement typically address the role of advancing age as a factor in developing disability, and in some cases have pointed out the importance of time to death (TTD) in understanding changes in functioning. However, few studies have addressed both factors simultaneously, and none have dealt satisfactorily with the problem of missing data on TTD in panel studies.

METHODS: We fit latent-class trajectory models of disablement using data from the Health and Retirement Study. Among survivors (~20% of the sample), TTD is unknown, producing a missing-data problem. We use an auxiliary regression equation to impute TTD and employ multiple imputation techniques to obtain final parameter estimates and standard errors.

RESULTS: Our best-fitting model has 3 latent classes. In all 3 classes, the probability of having a disability increases with nearness to death; however, in only 2 of the 3 classes is age associated with disability. We find gender, race, and educational differences in class-membership probabilities.

DISCUSSION: The model reveals a complex pattern of age- and time-dependent heterogeneity in late-life disablement. The techniques developed here could be applied to other phenomena known to depend on TTD, such as cognitive change, weight loss, and health care spending.

PB - 70 VL - 70 UR - http://psychsocgerontology.oxfordjournals.org/content/early/2015/04/23/geronb.gbu182.abstract IS - 5 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25740918?dopt=Abstract U2 - PMC4635644 U4 - Disability/Disability/Latent classes/Time to death/Trajectories ER - TY - JOUR T1 - Trends in late-life activity limitations in the United States: an update from five national surveys. JF - Demography Y1 - 2013 A1 - Vicki A Freedman A1 - Brenda C Spillman A1 - Patricia Andreski A1 - Jennifer C. Cornman A1 - Eileen M. Crimmins A1 - Kramarow, Ellen A1 - Lubitz, James A1 - Linda G Martin A1 - Sharon S. Merkin A1 - Robert F. Schoeni A1 - Teresa Seeman A1 - Timothy A Waidmann KW - Activities of Daily Living KW - Aged KW - Aged, 80 and over KW - Disabled Persons KW - Female KW - Health Surveys KW - Humans KW - Male KW - Mobility Limitation KW - Models, Statistical KW - United States AB -

This article updates trends from five national U.S. surveys to determine whether the prevalence of activity limitations among the older population continued to decline in the first decade of the twenty-first century. Findings across studies suggest that personal care and domestic activity limitations may have continued to decline for those ages 85 and older from 2000 to 2008, but generally were flat since 2000 for those ages 65-84. Modest increases were observed for the 55- to 64-year-old group approaching late life, although prevalence remained low for this age group. Inclusion of the institutional population is important for assessing trends among those ages 85 and older in particular.

PB - 50 VL - 50 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23104207?dopt=Abstract U2 - PMC3586750 U4 - methodology/Meta-analysis/ADL and IADL Impairments/Public Policy/health Care Costs/PREVALENCE ER - TY - JOUR T1 - Resolving inconsistencies in trends in old-age disability: report from a technical working group. JF - Demography Y1 - 2004 A1 - Vicki A Freedman A1 - Eileen M. Crimmins A1 - Robert F. Schoeni A1 - Brenda C Spillman A1 - Aykan, Hakan A1 - Kramarow, Ellen A1 - Land, Kenneth A1 - Lubitz, James A1 - Kenneth G. Manton A1 - Linda G Martin A1 - Shinberg, Diane A1 - Timothy A Waidmann KW - Activities of Daily Living KW - Age Factors KW - Aged KW - Aged, 80 and over KW - Chronic disease KW - Disabled Persons KW - Female KW - Health Surveys KW - Homemaker Services KW - Humans KW - Male KW - Models, Statistical KW - Self-Help Devices KW - United States AB -

In September 2002, a technical working group met to resolve previously published inconsistencies across national surveys in trends in activity limitations among the older population. The 12-person panel prepared estimates from five national data sets and investigated methodological sources of the inconsistencies among the population aged 70 and older from the early 1980s to 2001. Although the evidence was mixed for the 1980s and it is difficult to pinpoint when in the 1990s the decline began, during the mid- and late 1990s, the panel found consistent declines on the order of 1%-2.5% per year for two commonly used measures in the disability literature: difficulty with daily activities and help with daily activities. Mixed evidence was found for a third measure: the use of help or equipment with daily activities. The panel also found agreement across surveys that the proportion of older persons who receive help with bathing has declined at the same time as the proportion who use only equipment (but not personal care) to bathe has increased. In comparing findings across surveys, the panel found that the period, definition of disability, treatment of the institutionalized population, and age standardizing of results were important to consider. The implications of the findings for policy, national survey efforts, and further research are discussed.

PB - 41 VL - 41 IS - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/15461008?dopt=Abstract U4 - Disability/Disability/ADL and IADL Impairments/Elderly/Caregiving ER -