Disability Trends Among Elderly Persons and Implications for the Future

Abstract

Objectives. This article used a new data source to examine the issue of disability trends among elderly persons and examined the potential implications of these trends on future health and long-term care needs.Methods. We used the 1992-1996 Medicare Current Beneficiary Survey to examine time trends in rates of activities of daily living and instrumental activities of daily living disability and physical limitation among Medicare beneficiaries aged 65 and over. We used multinomial logit and least squares regression techniques to produce trend estimates that held the age, sex, race, and educational distributions constant and projected these trends into the future. Finally, we estimated the potential impact of disability decline on per capita Medicare spending on elderly persons.Results. We found that disability among elderly persons is declining and that the trend toward a more educated elderly cohort explains some, but not all, of this decline. In the absence of downward disability trends, per capita Medicare expenditures would have grown even faster than they have.Discussion. Although the decline in disability prevalence in recent years appears real, whether it continues has enormous implications for the size of the disabled population in the future and for the ability of the society to care for its disabled elderly members.NDERSTANDING trends in health and disability in older adult populations is crucial for public policy debates on pensions, retirement, and future health care spending. Considerable research has been done to gain such understanding. Some reports of trends in health and disability status have generated alarm about the possibility of rising disability rates, and other reports have produced relief from the prospect of falling rates. It is possible that both increasing and decreasing disability prevalence can be observed in the same population if trends are measured at different periods of time. However, attempts to reconcile these disparate observations raise important methodological questions about measurement of health and disability status over time.

Expansion of morbidity: trends in healthy life expectancy of the elderly population

“…Analyzes suggest that future changes in education levels would continue to contribute to improving the functionality of the populations. 31 A U.S. study showed by calculating DFLE between 1970 and 1990 that the compression of morbidity began with individuals with more years of education. 32 A study from Austria about educational disparity trends showed that, among women, there is a significant increase of the difference in healthy life expectancy between people from middle-and low-education backgrounds.…”

The Importance of Proximity to Death in Modelling Community Medication Expenditures for Older People: Evidence From New Zealand

“…Life expectancies are increasing in general and evidence suggests that these additional years are being lived in good health [40,41]. In order to use these results to more accurately model future data we need to consider increases and convergences in life expectancies.…”

Asociaciones entre la red social y la discapacidad al comienzo de la vejez en las ciudades de Madrid y Barcelona en 2005

“…Sin embargo, según el mismo estudio, en el caso de España la prevalencia en este grupo de edad es de un 35%, cifra semejante a la del presente estudio. Cotas similares se han encontrado en estudios realizados en Estados Unidos 1,[60][61][62] . Los datos del estudio europeo SHARE sitúan a España como el país con una mayor prevalencia de discapacidad, junto con Grecia y Francia (29% y 28% respectivamente).…”

“…Si bien la discapacidad no es una consecuencia inevitable del envejecimiento, las situaciones de fragilidad son crecientes a edades avanzadas, pudiendo desembocar en pérdida de autonomía y dependencia [1][2][3][4][5] . El deterioro funcional y cognitivo que se puede alcanzar en momentos avanzados de la vejez no se asocia tan sólo con el envejecimiento, sino también con el estilo de vida y las características del entorno del individuo.…”

“…A factores de riesgo conocidos como el nivel educativo, el nivel de ingresos, el estrato social, o los hábitos de vida [6][7][8]11,[15][16][17][18][19]24 se unen factores tales como la red social próxima del mayor, su integración social y participación, que afectan a la vulnerabilidad social del individuo, actuando como predictores de situaciones personales relativas a la salud, la autonomía funcional y cognitiva, el bienestar y la satisfacción entre las personas de edad 1,[13][14][15][16][17][18][19][20][21][22][23]25 .…”