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.

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Objective. To examine the strengths and limitations of the Center for Medicare and Medicaid Services' Chronic Condition Data Warehouse (CCW) algorithm for identifying chronic conditions in older persons from Medicare beneficiary data. Data Sources. Records from participants of the NHANES I Epidemiologic Follow-up Study (NHEFS 1971(NHEFS -1992 linked to Medicare claims data from 1991 to 2000. Study Design. We estimated the percent of preexisting cases of chronic conditions correctly identified by the CCW algorithm during its reference period and the number of years of claims data necessary to find a preexisting condition. Principal Findings. The CCW algorithm identified 69 percent of preexisting diabetes cases but only 17 percent of preexisting arthritis cases. Cases identified by the CCW are a mix of preexisting and newly diagnosed conditions. Conclusions. The prevalence of conditions needing less frequent health care utilization (e.g., arthritis) may be underestimated by the CCW algorithm. The CCW reference periods may not be sufficient for all analytic purposes. Key Words. CCW, NHEFS, Medicare claims, chronic conditionsAs the population ages and the treatment and management of chronic conditions such as heart disease, cancer, and diabetes has improved, the number of older people with one or more chronic conditions has increased (Vogeli et al. 2007). In 2005, among persons 65 and older, 91.5 percent had at least one chronic condition, and 76.6 percent had at least two chronic conditions. About 59 percent of all medical care expenses for persons age 65 and older were for treatment of chronic conditions (Machlin, Cohen, and Beauregard 2008).A significant body of research has used administrative databases to assess chronic conditions, but there are limitations in how well these data can identify a range of conditions, especially comorbid conditions (Taylor, r Health Research and Educational Trust

Oral health is an important and often overlooked component of an older person's general health and well-being. In the words of former Surgeon General C. Everett Koop: "You are not healthy without good oral health." 1 Oral health can affect general health in very direct ways. Oral health problems can cause pain and suffering as well as difficulty in speaking, chewing, and swallowing. These problems can also be a complication of certain medications used to treat systemic diseases. In addition, the treatment of systemic diseases can be complicated by oral bacterial infections. 2 There are also associations between oral health and general health and well-being. For example, the loss of self-esteem is associated with loss of teeth 3 and untreated disease (caries and periodontal diseases) as well as the economic burden of dental care due to the paucity of dental insurance programs for the elderly. Although oral health problems are not usually associated with death, oral cancers result in nearly 8,000 deaths each year, and more than half of these deaths occur among persons 65 years of age and older.