%0 Book Section %B New Models for Managing Longevity Risk: Public-Private Partnerships %D 2022 %T Does working longer enhance old age? %A Maria D Fitzpatrick %A Olivia S. Mitchell %K health %K Retirement %K working %B New Models for Managing Longevity Risk: Public-Private Partnerships %I Oxford University Press %@ 978–0–19–285980–8 %G eng %& 4 %R 10.1093/oso/9780192859808.001.0001 %0 Journal Article %J Health Serv Res %D 2015 %T Disaggregating activities of daily living limitations for predicting nursing home admission. %A Joelle H Fong %A Olivia S. Mitchell %A Benedict S K Koh %K Activities of Daily Living %K Age Factors %K Aged %K Aged, 80 and over %K Female %K Geriatric Assessment %K Homes for the Aged %K Humans %K Male %K Middle Aged %K Nursing homes %K Patient Admission %K Residence Characteristics %K Risk Factors %K Sex Factors %K Socioeconomic factors %X

OBJECTIVE: To examine whether disaggregated activities of daily living (ADL) limitations better predict the risk of nursing home admission compared to conventionally used ADL disability counts.

DATA SOURCES: We used panel data from the Health and Retirement Study (HRS) for years 1998-2010. The HRS is a nationally representative survey of adults older than 50 years (n = 18,801).

STUDY DESIGN: We fitted Cox regressions in a continuous time survival model with age at first nursing home admission as the outcome. Time-varying ADL disability types were the key explanatory variables.

PRINCIPAL FINDINGS: Of the six ADL limitations, bathing difficulty emerged as the strongest predictor of subsequent nursing home placement across cohorts. Eating and dressing limitations were also influential in driving admissions among more recent cohorts. Using simple ADL counts for analysis yielded similar adjusted R(2) s; however, the amount of explained variance doubled when we allowed the ADL disability measures to time-vary rather than remain static.

CONCLUSIONS: Looking beyond simple ADL counts can provide health professionals insights into which specific disability types trigger long-term nursing home use. Functional disabilities measured closer in time carry more prognostic power than static measures.

%B Health Serv Res %I 50 %V 50 %P 560-78 %8 2015 Apr %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25256014?dopt=Abstract %2 PMC4369222 %4 ADL/IADL/Long Term Care/Nursing home placement %$ 999999 %R 10.1111/1475-6773.12235 %0 Report %D 2012 %T Functional Disabilities and Nursing Home Admittance %A Joelle H Fong %A Benedict S K Koh %A Olivia S. Mitchell %K Disabilities %K Hospitalization %K Long-term Care %K Mortality %K Older Adults %X This paper examines how inability to perform activities of daily living relates to the risk of nursing home admission over older adults' life courses. Using longitudinal data on persons over age 50 from the Health and Retirement Study, we show that aging one year boosts the probability of having two or more disabilities by 9 to 12 percent in a multivariate logistic model. Moreover, at least three-fifths of all 65-year-old men and three-quarters of women will experience disability levels during their remaining lifetimes severe enough to trigger nursing home admission. Our analysis also suggests that certain types of disability are more important than others in predicting nursing home admittance and use, which has implications for the design and benefits triggers for long-term care insurance programs. %B Pension Research Council Working Paper %I Pension Research Council, University of Pennsylvania %C Philadelphia, PA %G eng %R 10.2139/ssrn.2157548 %0 Book Section %B Privatizing Social Security %D 1998 %T Privatizing Social Security: First Round Effects of a Generic Voluntary Privatized U.S. Social Security System %A Alan L Gustman %A Olivia S. Mitchell %A Thomas L. Steinmeier %E Feldstein, M.S. %K Methodology %K Public Policy %K Social Security %B Privatizing Social Security %I University of Chicago Press %C Chicago, IL %P 313-57 %G eng %4 Social Security Research/Privatization/Public Policy %$ 8646 %! Privatizing Social Security: First Round Effects of a Generic Voluntary Privatized U.S. Social Security System