Persistent, consistent, widespread, and robust? Another look at recent trends in old-age disability

Objective. The purpose of this study was to provide new evidence on disabil ity trends among elderly persons from 1982 to 1996. Methods. The sample includes 125,949 participants aged 70 and older in the 1982-1996 National Health Interview Surveys. Logistic analysis was used to estimate the trend in disability prevalence after controlling for various s ociodemographic factors. Results. We found that: (a) the prevalence of disability has declined, but the gains did not persist throughout the entire period or accelerate over t ime: (b) only routine care disability has declined. whereas more severe per sonal care disability shows no improvements; (c) estimates are robust to th e exclusion of the nursing home population but may be sensitive to growth i n the assisted living population: (d) estimates of decline in disability pr evalence are fairly consistent across five national surveys: (e) gains have been concentrated among the most educated elderly persons: and (F) gains i n education appear to be an important confounder of the improvements. Discussion. Evidence from several surveys using various measures indicate t hat disability has declined among elderly persons. Determining the causes o f the improvements should be a high priority in future research efforts.