Recent Trends in Disability and Functioning Among Older Adults in the United States

Freedman, Vicki A.; Martin, Linda G.; Schoeni, Robert F.

doi:10.1001/jama.288.24.3137

Cited by 756 publications

(514 citation statements)

References 45 publications

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“…Compared to many surveys from larger countries the SWEOLD samples are small (Freedman et al 2002). However, in order to ensure highly representative samples of the Swedish population aged 77 years and older, SWEOLD includes institutionalized, cognitively impaired persons and proxy interviews.…”

Section: Discussionmentioning

confidence: 99%

“…Empirical investigations of health trends in the elderly population have predominantly investigated single health items. Most of these studies concern disability and point toward improvements during the 1980s and early 1990s, e.g., in the USA (Crimmins 2004;Freedman et al 2002), Sweden (Ahacic et al 2000(Ahacic et al , 2003Lagergren and Batljan 2000;Rosen and Haglund 2005;Steen 2002;Wilhelmson et al 2002) and Finland (Malmberg et al 2002). With respect to symptoms and diseases there is no uniform trend.…”

Section: Introductionmentioning

confidence: 99%

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Complex health problems in the oldest old in Sweden 1992–2002

et al. 2006

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Most studies on health trends in the elderly population focus on specific conditions, studied one at a time. However, health problems are often interrelated and exist simultaneously in late life. Individuals with health problems in several domains present special challenges to care services. To estimate future needs for care it may be relevant to study trends of complex health problems as well as single health items. This study identified serious problems in three domains (diseases/ symptoms, mobility, cognition/communication) in two representative samples of the Swedish population aged 77 and older (1992: n=537; 2002: n=561). People with serious problems in two or three domains were considered to have complex health problems. Changes between 1992 and 2002 in the prevalence of persons having serious problems in no, one and two/three domains were analyzed with logistic regressions. When examining each domain separately all three showed a significant increase of serious problems. For diseases/symptoms the increase remained significant after controlling for different age and gender distributions in the two surveys. Results showed a significant increase in the prevalence of having problems in one domain, as well as having problems in two or three domains (complex problems). Results persisted when adjusting for different distributions in age, gender and education between 1992 and 2002. Results suggest a worsening of health during the 10-year period and an increase of complex problems. This emphasizes the necessity of cooperation and collaboration between different kinds of medical and social services for elderly people.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Complex health problems in the oldest old in Sweden 1992–2002

et al. 2006

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“…It is expensive for the long term care system, where about half of the residents may suffer from dementia, a substantial proportion of whom can no longer afford their own care. Although people are now reaching their older years in better health, 5,6 it remains to be seen whether there will be a decrease in the incidence of AD. Currently the fastest growing element of the population is among those 85 years of age and older, the age group where the incidence of AD is greatest.…”

Section: Introductionmentioning

confidence: 99%

Consortium to Establish a Registry for Alzheimer's Disease (CERAD): The first twenty years

Fillenbaum

Belle

Morris

et al. 2008

Alzheimer's & Dementia

384

274

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The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) was funded by the National Institute on Aging in 1986 to develop standardized, validated measures for the assessment of Alzheimer's disease (AD). The present report describes the measures that CERAD developed during its first decade, and their continued use in their original and translated forms. These measures include clinical, neuropsychological, neuropathological and behavioral assessments of AD, and also assessment of family history and parkinsonism in AD. An approach to evaluating neuroimages did not meet the standards desired. Further evaluations which could not be completed because of lack of funding (but where some materials are available), include evaluation of very severe AD, and of service use and need by patient and caregiver. The information that was developed in the U.S. and abroad permits standardized assessment of AD in clinical practice, facilitates epidemiological studies, and provides information valuable for individual and public health planning. CERAD materials and data remain available for those wishing to use them. KeywordsConsortium to Establish a Registry for Alzheimer's Disease; CERAD; Alzheimer's disease; clinical assessment; neuropsychological assessment; neuropathological assessment; norms; prevalence; incidence BackgroundDementing disorders have long been recognized, 1 with the identification of Alzheimer's disease (AD) typically dated back to Alzheimer's century-old paper. 2 Although considerable attention has been paid to Alzheimer's disease and substantial progress has been made in identifying its characteristics, nevertheless much remains unclear. As diagnostic procedures improve, the complexities of this disease become more apparent, and the threat it imposes becomes increasingly evident. In the population 65 years of age and older, both the incidence and prevalence of this disorder double every succeeding five years, 3 with estimated prevalence as high as 40% among those over the age of 85. AD, not recognized as a leading cause of death in 1980, was recognized as the fifth leading cause of death in 2003 among persons 65 years of age and older. 4 There is presently no cure and inadequate amelioration for this condition. It can not only strip personality and capability, but is demanding on family members, seriously disrupting their lives and their work. It is expensive for the long term care system, where about half of the residents may suffer from dementia, a substantial proportion of whom can no longer afford their own care. Although people are now reaching their older years in better health, 5,6 it remains to be seen whether there will be a decrease in the incidence of AD. Currently the fastest growing element of the population is among those 85 years of age and older, the age group where the incidence of AD is greatest.A major step in the management of a disease lies in accurate diagnosis. Relevant to current work, clinical diagnostic criteria for dementia and AD were specified about 25 years ago, and the...

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“…In the case of the US in 2000, 65% of the total expenditure on LTC (US$ 123 billion) was met through the Medicaid and Medicare federal state based health programs (Freedman, Martin, & Schoeni, 2002). By 2004, expenditure on LTC in the US had risen to US$ 134.9 billion nationally, with Medicaid accounting for 35.1% of the cost, despite the US government's overall share of the total expenditure falling by 5.7% to 59.3% (Congressional Budget Office, 2004).…”

Section: Expenditure On Long-term Carementioning

confidence: 99%