|
| ||||||
MEDIA CENTER Analysis Confirms That Older Americans Are Less Disabled: NEW YORK (9 January 2003) — A recent analysis of results from eight national surveys confirms a decline in some of the disabilities and limitations in functioning that commonly plague older Americans. These findings, by Population Council president Linda Martin and two co-authors, were published in the 25 December issue of the Journal of the American Medical Association (JAMA). Although disability and limitation are not inevitable consequences of aging, Martin, Vicki A. Freedman, and Robert F. Schoeni note, 20 percent of older Americans suffer from a chronic disability-the inability to carry out specific tasks or activities independently. Some older Americans also experience restrictions in more basic physical movements, sensory abilities, and memory-related tasks. In addition to affecting individuals' quality of life and ability to continue working disabilities and limitations have implications for demands on the time of family members who provide substantial uncompensated informal care to those in need. Further, the authors note, "The cost of medical care for a disabled older person averages 3 times that for a nondisabled senior," with more than 65 percent of the $123 billion spent in 2000 on long-term health care for older Americans being covered by US taxpayers. In the JAMA article, the researchers observe that several recent studies using eight different national surveys and a variety of measures of disability have found a decline in disabilities and limitations among older Americans. Despite the importance of these findings, they had not previously been synthesized and critically reviewed. With support from the National Institute on Aging (NIA), the authors developed criteria to evaluate these reports of improvements in functioning and to assess whether they were widespread across sex, race, and education groups in the population. The greatest improvements appear to have occurred in the ability to carry out so-called instrumental activities of daily living, such as household chores and shopping, which were measured in four of the surveys. For example, analysis of the National Health Interview Survey found that the proportion of people ages 70 and over who needed help with such activities declined from 14.5 percent in 1982 to 10.9 percent in 1996, yielding an average annual rate of decline of 1.66 percent. The rate of decline ranged from .40 percent to 2.74 percent per year across the other three surveys using this measure. "Taken together, the evidence suggests that America has been aging gracefully," notes Dr. Freedman. Less clear is the evidence for trends in activities of daily living, such as bathing and feeding oneself, difficulties with which are less common but are concentrated among the most severely disabled. Some surveys indicated declines, while others suggested increases. Evidence regarding trends in limitations in cognition and such basic physical tasks as walking and climbing showed consistent declines, but only one or two surveys assessed each of these measures, so the evidence base is thin. The review also found that evidence about differentials across population groups and about what is driving the declines is limited. The authors conclude, "Without better insight into the causes of these improvements, it remains unclear whether medical expenditures have fueled health improvements or whether health improvements will help save medical costs in the future." Richard M. Suzman, Ph.D., associate director of the NIA's Behavioral and Social Research Program, commented, "The findings that disability is declining among older people have important implications, and Martin, Freedman, and Schoeni have provided a needed review of the quality and strength of studies in this area. We must continue to monitor the trend and try to understand what is driving it."
|
