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Disability Rises Gradually for a Cohort of Older Americans.

Lois M Verbrugge1, Dustin C Brown2, Anna Zajacova3

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The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
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PubMed
Summary

Average disability among older Americans increases gradually over time. Near death, disability rises sharply, but longer-living individuals experience slower increases.

Keywords:
ChangeCohortDisabilityFrailtyOlder Ages

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Area of Science:

  • Gerontology
  • Epidemiology
  • Sociology of Aging

Background:

  • Understanding long-term disability trends in aging populations is crucial for healthcare planning.
  • The Study of Asset and Health Dynamics Among the Oldest Old (AHEAD) provides longitudinal data on health and economic status.
  • Previous research has not fully elucidated disability trajectories within a consistently aging cohort.

Purpose of the Study:

  • To examine changes in average disability over nearly two decades within a large epidemiological cohort of older Americans.
  • To determine if average disability levels for the living cohort rise rapidly, gradually, stay steady, or decline as individuals age and some exit the cohort due to mortality.
  • To compare disability histories between decedent and survivor groups within the cohort.

Main Methods:

  • Utilized data from the Study of Asset and Health Dynamics Among the Oldest Old (AHEAD) cohort spanning 1993-2010.
  • Analyzed personal care disability (activities of daily living), household management disability (instrumental activities of daily living), and physical limitations.
  • Compared average disability trends for the living cohort and examined disability trajectories for decedent and survivor subgroups, stratified by baseline age, sex, and survival duration.

Main Results:

  • Average disability among the living cohort demonstrated a gradual increase over the study period.
  • Decedent groups exhibited higher average disability compared to earlier decedent groups, with a sharp rise near death.
  • Longer-surviving groups showed less average disability and slower increases compared to shorter-surviving groups, consistent across different age and sex subgroups.

Conclusions:

  • Average disability among living cohort members increases gradually as the cohort ages.
  • These gradual increases suggest maintained behavioral, psychological, and biological fitness among the very old.
  • The findings highlight distinct disability trajectories for survivors and those who die during the observation period.