Research Paper
Trends in disability and related chronic conditions among the forty-and-over population: 1997–2010

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Abstract

Background

Downward trends in activity limitations among the older U.S. population have recently plateaued, while activity limitation among the pre-retirement population has increased.

Objectives

Update temporal trends in limitations in sensory and physical functions, instrumental activities of daily living (IADLs), and activities of daily living (ADLs) for the 40–64 and 65-and-over U.S. populations; assess the extent to which trends in education, smoking, and obesity could account for the trends in limitations; and examine trends in conditions cited as causes of limitations, their durations, and proportion of life spent with them.

Methods

Multivariate analysis of the 1997–2010 National Health Interview Survey.

Results

For the younger group, there have been increases in all limitations, except trouble hearing, which has declined. Increased obesity could account for the increases in vision, physical function, and IADL limitations. Musculoskeletal conditions, such as arthritis and back/neck problems, are frequently cited as causes of limitation, and there are growing roles for depression and nervous system conditions.

For the 65-and-over group, there have been decreases in all limitations, except difficulty with physical functions, which is up. Increased education could account for the decline in ADL limitation, and increased obesity could account for increased difficulty with physical functions. Musculoskeletal conditions are also frequently cited as causes of limitation, but declines in heart- and vision-related limitations have been important.

Conclusion

Trends should continue to be monitored closely for both groups, since younger people have not experienced the improvements of the older group, but are its future members.

Section snippets

Data

We used data for people ages 40 and older from the 1997–2010 National Health Interview Survey (NHIS), which is a nationally representative annual survey of the non-institutionalized population of the United States. The family core questionnaire of the survey ascertains information on all members of the sample household about need for help with routine needs and personal care, as well as demographic and socioeconomic characteristics. An additional interview of a sample adult from each sample

Results

Fig. 1 shows the unadjusted trends in limitations from 1997 to 2010 for the 40–64 group. Over a third of this younger population reported difficulty with at least one of the nine physical functional limitations. The most difficult physical functions were stooping, standing, pushing, and walking—all functions involving mobility (not shown). After the physical functions, the 40–64 group had the most trouble with the sensory functions of hearing and vision. Needing help with IADLs and ADLs have

Discussion

People ages 40–64 years are increasingly reporting difficulty with physical functions and need for help with IADLs and ADLs. The recent increase in ADL limitation in this younger population has previously been highlighted by Martin, Freedman, and colleagues (using NHIS data for ages 50–64 from 1997 to 2007)5 and by Martin, Schoeni, and Andreski (using NHIS data for ages 40–64 from 1997 to 2008).6 The increase in need for help with ADLs for females ages 40–64 is especially large. The significant

Conclusion

The continued increase in limitations among the 40–64-year-old population through 2010 is troubling, especially since its members represent the future older population. However, the rates of ADL and IADL disability for this younger population remain quite low, affecting fewer than 4%, and it remains to be seen the extent to which these trends reflect increased survival with early-onset disability. For physical function and IADL limitation, the rise in limitations is associated with the rise in

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  • Cited by (0)

    Support for development of this paper was provided by the National Institute on Aging grant no. P30 AG012846 to the University of Michigan and P30 AG034464 to Syracuse University.

    Prior presentation: A similar version of this paper was presented orally at the meeting titled, “Aging with disability: Demographic, social, and policy considerations,” organized by the Interagency Committee on Disability Research in Washington, D.C. on May 17–18, 2012.

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