The expected cumulative health expenditures for healthier elderly persons, despite their greater longevity, were similar to those for less healthy persons. Health-promotion efforts aimed at persons under 65 years of age may improve the health and longevity of the elderly without increasing health expenditures.

In September 2002, a technical working group met to resolve previously published inconsistencies across national surveys in trends in activity limitations among the older population. The 12-person panel prepared estimates from five national data sets and investigated methodological sources of the inconsistencies among the population aged 70 and older from the early 1980s to 2001. Although the evidence was mixed for the 1980s and it is difficult to pinpoint when in the 1990s the decline began, during the mid- and late 1990s, the panel found consistent declines on the order of 1%-2.5% per year for two commonly used measures in the disability literature: difficulty with daily activities and help with daily activities. Mixed evidence was found for a third measure: the use of help or equipment with daily activities. The panel also found agreement across surveys that the proportion of older persons who receive help with bathing has declined at the same time as the proportion who use only equipment (but not personal care) to bathe has increased. In comparing findings across surveys, the panel found that the period, definition of disability, treatment of the institutionalized population, and age standardizing of results were important to consider. The implications of the findings for policy, national survey efforts, and further research are discussed.

This article updates trends from five national U.S. surveys to determine whether the prevalence of activity limitations among the older population continued to decline in the first decade of the twenty-first century. Findings across studies suggest that personal care and domestic activity limitations may have continued to decline for those ages 85 and older from 2000 to 2008, but generally were flat since 2000 for those ages 65–84. Modest increases were observed for the 55- to 64-year-old group approaching late life, although prevalence remained low for this age group. Inclusion of the institutional population is important for assessing trends among those ages 85 and older in particular.

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One of the most dramatic changes in the life of the elderly in the United States in the twentieth century is the rise in the proportion of elderly widows living alone. This paper examines this transformation by comparing the determinants of elderly widows' living alone at four points in time, in 1910, 1940, 1960, and 1990. Logistic regression models of the probability of living alone are estimated. The results of these models are used to calculate the expected proportion of elderly widows living alone in various hypothetical scenarios of social change. This analysis suggests that no single factor is responsible for the rise in living alone among the elderly. Value changes, as represented by a variable for time, are shown to have strong and direct effects on the increased probability of living alone in old age in the late twentieth century, independent of the effect of rising income levels. These results are discussed in light of previous research on living arrangements of the elderly, which articulates demographic, economic, and cultural explanations for change.