Objectives. This study explored whether improvements in cognitive functioni
ng occurred during the 1990s among older Americans and investigated several
possible explanations for such changes.
Methods. Using the 1993 Asset and Health Dynamics of the Oldest Old study (
N = 7,443) and 1998 Health and Retirement Survey (N = 7.624). this study ex
amined aggregate changes in the proportion of the noninstitutionalized popu
lation aged 70 and older with severe cognitive impairment. impairment was m
easured for self-respondents using a modified version of the Telephone Inte
rview Cognitive Screen: for proxy respondents, ratings of memory and judgme
nt were used. Logistic regression was used to investigate potential explana
tions for aggregate changes.
Results. The percentage of older Americans with severe cognitive impairment
declined from 6.1% in 1993 to 3.6% in 1998 (p < .001). The decline was sta
tistically significant among self-respondents bur nor among those with prox
y interviews. Improvements between 1993 and 1998 were not explained by shif
ts in demographic and socioeconomic factors or by changes in the prevalence
of stroke, vision, or hearing impairments.
Discussion. As a group, older persons, especially those well into their 80s
, appear to have better cognitive functioning today than they did in the ea
rly 1990s.