Reducing Disability in Older Age

Abstract

In this issue of THE JOURNAL, Freedman and colleagues¹ present encouraging evidence from a number of sources that disability in seniors is decreasing. The authors identified and reviewed 16 articles based on 8 surveys that assessed US trends in the prevalence of self-rated older adult disability and physical, cognitive, and sensory limitations among older adults beginning in 1982 through 1999. Of the studies assessed as having at least fair quality, surveys showed consistent declines in instrumental activities of daily living (IADLs) and in functional limitations. These findings are conservatively presented and all are consistent with the single best study, the report by Manton and Gu,² which presents the most recent data, has the most detailed end points, surveys the most representative sample of the US population, and shows the most striking findings. Manton and Gu studied trends in disability in the National Long Term Care Surveys (NLTCS) of 1982, 1989, 1994, and 1999 of the Medicare-eligible population aged 65 years and older, which include both institutionalized and noninstitutionalized individuals.