Contribution of chronic conditions to aggregate changes in old-age functioning

Abstract

OBJECTIVES: This study explored the role of various chronic conditions in explaining recent improvements in functioning among older Americans. METHODS: We used the Supplements on Aging to the 1984 and 1994 National Health Interview Surveys to examine changes among Americans 70 years and older in reports of chronic conditions and functional limitations. We decomposed functioning changes into condition-related components, controlling for demographic shifts. RESULTS: The percentage of older Americans with upper- and lower-body limitations declined from 5.1% and 34.2%, respectively, in 1984 to 4.3% and 28.5% in 1995, and the average number of lower body limitations decreased. During the same period, reports of 8 of 9 chronic conditions increased, but many of these conditions had less debilitating effects on functioning. Reductions in the debilitating effects of various chronic conditions--particularly arthritis--are important in explaining declines in limitations experienced by older Americans. CONCLUSIONS: Earlier diagnosis and improved treatment and management of chronic conditions, rather than prevention, may be important contributing factors to improvements in upper- and lower-body functioning among older Americans.

The Dynamic contribution of chronic conditions to temporal trends in disability among U.S. adults

“…7 All of the above evidence suggests that the potentially disabling impacts of chronic disease can be reduced over time. Further confirmation comes from previous studies 6, 9 that link disability trends with chronic conditions and demonstrate a divergent trend between certain types of disability and some major chronic conditions.…”

“…This declining contribution from chronic conditions among more recent cohorts aligns with earlier evidence that chronic conditions are becoming less disabling. 6-9 Coupling this fact with the increasing IADL disability across newer cohorts, 18 it is puzzling as to what, if not increasing chronic conditions, might be causing the IADL disability increase among recent cohorts. It is plausible that other competing risk factors are contributing to IADL disability.…”

Trends in health of older adults in the United States: Past, present, future

“…In contrast, the increase in late-life obesity, while not playing a major role in disability trends, did dampen the decreases (Freedman and Martin 2000; Freedman et al 2007). Using NHANES data from 1988–1994 to 1999–2004, Alley and Chang (2007) found that the odds of ADL disability did not increase for the obese population aged 60 and older, but the odds of ADL disability among the obese relative to the odds among the non-obese increased over time because ADL disability declined among the non-obese.…”

“…Analyses of data for the population aged 70 and older from the 1984 and 1994–1995 Supplements on Aging (SOA) to the NHIS found increases in the prevalence of self-reports of many chronic conditions, including arthritis, heart disease, cancer, diabetes, stroke, and osteoporosis (Crimmins and Saito 2000; Freedman and Martin 2000). These changes in prevalence reflect the interplay of changes in awareness of specific conditions, diagnosis, incidence, treatment, and survival.…”

“…Analyses of data from the Survey of Income and Program Participation (SIPP) for the 1980s and 1990s for the population aged 50 to 64 and those aged 65 and older (Cutler 2001; Freedman and Martin 1998) and from the 1984 and 1994–1995 SOA for the population aged 70 and older (Crimmins and Saito 2000; Freedman and Martin 2000) also indicated declines in limitations with such physical functions as climbing a flight of stairs, walking a quarter mile, and lifting and carrying a 10- or 25-pound weight. However, a study using NHIS data for ages 40 to 59 found no significant change for the 1997–2006 period (Martin et al 2009).…”