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.

Purpose: This study examined the prevalence, correlates, and negative consequences of unmet need for personal assistance with activities of daily living (ADLs) among older adults. Design and Methods: The authors analyzed crosssectional data from the 1994 National Health Interview Survey's Supplement on Aging. Data were weighted to be representative of the noninstitutionalized population aged 70 years and older. Results: Overall, 20.7% of those needing help to perform 1 or more ADLs (an estimated 629,000 persons) reported receiving inadequate assistance; for individual ADLs, the prevalence of unmet need ranged from 10.2% (eating) to 20.1% (transferring). The likelihood of having 1 or more unmet needs was associated with lower household income, multiple ADL difficulties, and living alone. Nearly half of those with unmet needs reported experiencing a negative consequence (e.g., unable to eat when hungry) as a result of their unmet need. Implications: Greater, targeted efforts are needed to reduce the prevalence and consequences of unmet need for ADL assistance in elderly persons.

H i g h l i g h t s l Nineteen percent of persons 70 years of age and older had visual impairments. Visual impairments, including blindness, increased with age; the level of blindness among older Americans has remained constant between 1984 and 1995.

No abstract

The health of Americans age sixty-five and older has improved on nearly all major indicators: longevity, self-reported health, and functioning. Both health care services use and health spending have risen. The increased use of restorative procedures and prescription medicines suggests that medical advances have had an important role in the better health of older Americans. Factors that might limit prospects for future improvements include rising rates of obesity and diabetes, particularly among the middle-aged.