Update in Geriatric Medicine

Health Promotion and Disease Prevention

Disability in Old Age Decreased in Recent Years

In just the past decade or so, the United States has seen incredible growth in its elderly population, including an 8-fold growth in persons between the ages of 65 to 74 years, a 15-fold increase in persons between the ages of 75 to 84 years, and a 36-fold increase in people 85 years of age and older. This study explored whether the aging population is spending these extra years active or more disabled.

The investigators reviewed several studies from the 1980s and 1990s that focused on changes in function among the elderly. From more than 800 articles, they selected 16 that were based on 8 unique repeated cross-sectional and cohort surveys of U.S. prevalence trends in disability or functioning. The studies generally involved patients age 65 years or older. The papers were rated as “good,” “fair,” or “poor,” on the basis of 10 quality criteria. Of the 8 surveys, the investigators rated 2 as “good,” 4 as “fair,” 1 as “poor,” and 1 as “mixed” (“fair” or “poor,” depending on the outcome being assessed). For each outcome, the average annual percentage of change was calculated.

Surveys rated as “fair” or “good” showed an annual consistent decline in any disability (−1.55% to −0.92%), in instrumental activities of daily living disability (−2.74% to −0.40%), and in functional limitations. The surveys provided limited evidence on cognition and conflicting evidence on self-reported activities of daily living (changes ranged from −1.38% to …