Toronto, ON – A sizeable improvement was found in the prevalence of American adults aged 65 and older without disabilities -- including memory, hearing, visual, and functional disabilities or limitations in activities of daily living -- according to a new nationally representative study published online in the Archives of Gerontology and Geriatrics Plus found.
In total, 61% of older Americans reported being free from disability in 2008. The prevalence increased to 65% in 2017. While this may seem like a small increase, had the prevalence of individuals without disabilities remained at 2008 levels, an additional 2.07 million older Americans would have at least one serious disability in 2017.
"Such a dramatic improvement over such a short period of time was extremely encouraging to see," says senior author Esme Fuller-Thomson, Director of the University of Toronto's Institute for Life Course & Aging and professor at the Factor-Inwentash Faculty of Social Work (FIFSW) and Department of Family & Community Medicine. "Those who are free of disabilities are less likely to need extensive health and long-term care services and find it easier to maintain their quality of life."
This study analyzed data from 10 consecutive waves of the nationally representative cross-sectional American Community Survey (2008-2017). Approximately half a million respondents aged 65 and older provided information each year, resulting in a final sample size of 5.4 million older Americans. Respondents were asked to report if they had "serious difficulty" with five common types of disabilities. Individuals were defined as being free from disability if they reported that they did not have serious memory problems, hearing problems, vision problems, limitations in activities of daily living (such as bathing or dressing), or functional limitations (such as walking or climbing stairs).
In 2008, women were less likely to be free of disability than men (59.4% versus 62.7%, respectively). Women had a steeper rate of improvement over the decade than their male peers. By 2017, the gender gap had been closed, with the prevalence of being disability-free almost the same for women and men (64.7% versus 65.0%, respectively).
"The post-war generations were more likely to complete high school and university, and these trends may play an integral role in the improved prevalence of older adults with disability free life," says co-author Deirdre Kelly-Adams, a recent Master of Social Work graduate from University of Toronto's FIFSW. "Higher educational attainment decreases the likelihood of engaging in negative health behaviours such as smoking, and can lead to less physically demanding jobs, both of which are associated with a reduction in later life disability".
While such a positive improvement in the prevalence of older adults living without disabilities between 2008 and 2017 was observed, the authors discuss the possibility that the rate of improvement may diminish in the coming decades. Most of the improvement was seen among those aged 75 and older. There was little improvement over the decade study among those aged 65-74, which is representative of the baby boom generation. Although the current study does not reveal why there was less improvement among Baby Boomers, the authors suggest this may be related to higher rates of obesity among Baby Boomers compared to older generations.
"Further research will be needed to investigate whether we will continue to see these positive trends moving forward, particularly among the Baby Boomer generation," said Fuller-Thomson. "There is also a need to identify the mechanisms driving the difference in rate of improvement between men and women."
