The racial crossover in comorbidity, disability, and mortality

Area of Science:

• Gerontology
• Epidemiology
• Health Disparities Research

Background:

• The Survey on Asset and Health Dynamics Among the Oldest Old (AHEAD Survey) tracks health and financial status of older Americans.
• Understanding age-related changes in health and mortality across racial groups is crucial for public health interventions.

Purpose of the Study:

• To analyze racial crossovers in comorbidity, disability, and mortality among older adults.
• To investigate the relationship between comorbidity, disability, and mortality crossovers.

Main Methods:

• Analysis of Wave 1 (1993-1994) and Wave 2 (1995-1996) data from the AHEAD Survey.
• Inclusion criteria: respondents aged 70+ at Wave 1 with determinable survival status at Wave 2.
• Examination of cumulative diagnoses (chronic lung disease, cancer, heart disease, hypertension, diabetes, stroke) and Advanced Activities of Daily Living (AADLs).

Main Results:

• A racial crossover in cumulative diagnoses occurred at age 76, with whites having higher averages than blacks.
• A racial crossover in Advanced Activities of Daily Living (AADLs) disability occurred at age 86, with whites exceeding blacks.
• A racial crossover in mortality odds occurred around age 81, with whites having higher odds than blacks.

Conclusions:

• The study observed significant racial crossovers in comorbidity, disability, and mortality among the oldest old.
• The findings suggest that the crossover in comorbidity, not disability, likely drove the crossover in mortality.
• These results highlight the dynamic nature of racial health disparities in aging populations.