Objective: Disability declined in lower levels of impairment during the late 20th century. However, it is unclear whether ADL disability also declined, or whether it did so across race. In this study, we examine cohorts entering later life between 1984 and 1999, by race, to understand changing ADL disability. Method: We used latent class methods to model trajectories of ADL disability and subsequent mortality in the National Long-Term Care Survey among cohorts entering older adulthood (ages 65-69) between 1984 and 1999. We examined patterns by race, focusing on chronic condition profiles. Results: White cohorts experienced consistent declines in ADL disability but Blacks saw little improvement with some evidence for increased disability. Stroke, diabetes, and heart attack were predominant in predicting disability among Blacks. Discussion: Declining disability trends were only observed consistently among Whites, suggesting previous and future disability trends and their underlying causes should be examined by race.
ClarkD. O. (1997). US trends in disability and institutionalization among older blacks and whites. American Journal of Public Health, 87, 438-440. doi:10.2105/AJPH.87.3.438
2.
CloggC. C.PetkovaE.HaritouA. (1995). Statistical methods for comparing regression coefficients between models. American Journal of Sociology, 100, 1261-1293. doi:10.1086/230638
3.
CollinsL. M.LanzaS. T. (2010). Latent class and latent transition analysis: With applications in the social, behavioral, and health sciences. Hoboken, NJ: John Wiley.
4.
CrimminsE.KimJ. K.VasunilashornS. (2010). Biodemography: New approaches to understanding trends and differences in population health and mortality. Demography, 47, S41-S64. doi:10.1353/dem.2010.0005
5.
CrimminsE. M.SaitoY. (2000). Change in the Prevalence of diseases among older Americans: 1984-1994. Demographic Research, 3(9). doi:10.4054/DemRes.2000.3.9
6.
FreedmanV. A.MartinL. G.SchoeniR. F. (2002). Recent trends in disability and functioning among older adults in the United States: A systematic review. The Journal of the American Medical Association, 288, 3137-3146. doi:10.1001/jama.288.24.3137
7.
FreedmanV. A.MartinL. G.ShinbergD.WaidmannT.CrimminsE.SchoeniR. F.. . . MantonK. (2004). Resolving inconsistencies in trends in old-age disability: Report from a technical working group. Demography, 41, 417-441. doi:10.1353/dem.2004.0022
8.
FreedmanV. A.SchoeniR. F.MartinL. G.CornmanJ. C. (2007). Chronic conditions and the decline in late-life disability. Demography, 44, 459-477. doi:10.1353/dem.2007.0026
9.
FreedmanV. A.SchoeniR. F.SeemanT. E.WaidmannT. A.SpillmanB. C.AndreskiP. M.. . . MerkinS. S. (2013). Trends in late-life activity limitations in the United States: An update from five national surveys. Demography, 50, 661-671. doi:10.1007/s13524-012-0167-z
10.
GeronimusA. T.BoundJ.WaidmannT. A.ColenC. G.SteffickD. (2001). Inequality in life expectancy, functional status, and active life expectancy across selected black and white populations in the united states. Demography, 38, 227-251. doi:10.1353/dem.2001.0015
11.
GillT. M.GahbauerE. A.LinH.HanL.AlloreH. G. (2013). Comparisons between older men and women in the trajectory and burden of disability over the course of nearly 14 years. Journal of the American Medical Directors Association, 14, 280-286. doi:10.1016/j.jamda.2012.11.011
12.
HaywardM. D.HeronM. (1999). Racial inequality in active life among adult Americans. Demography, 36, 77-91. doi:10.2307/2648135
13.
JohnsonR.WienerJ. (2006). Profile of frail older Americans and their caregivers (The Retirement Project, Occasional Paper Number 8). Washington, DC: The Urban Institute. Retrieved from http://www.urban.org/UploadedPDF/311284_older_americans.pdf
14.
KatzS.FordA. B.MoskowitzR. W.JacksonB. A.JaffeM. W. (1963). Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function. The Journal of the American Medical Association, 185, 914-919. doi:10.1001/jama.1963.03060120024016
15.
LawtonM. P.BrodyE. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179-186. doi.org/10.1093/geront/9.3_Part_1.179
16.
LazarsfeldP. F.HenryN. W. (1968). Latent structure analysis. New York, NY: Houghton Mifflin.
17.
LiangJ.XuX.BennettJ. M.YeW.QuiñonesA. R. (2010). Ethnicity and changing functional health in middle and late life: A person-centered approach. The Journals of Gerontology, Series B: Psychological Sciences & Social Sciences, 65, 470-481. doi:10.1093/geronb/gbp114
18.
LinS. F.BeckA. N.FinchB. K.HummerR. A.MasterR. K. (2012). Trends in US older adult disability: Exploring age, period, and cohort effects. American Journal of Public Health, 102, 2157-2163. doi:10.2105/ajph.2011.300602
19.
LynchS. M. (2003). Cohort and life-course patterns in the relationship between education and health: A hierarchical approach. Demography, 40, 309-331. doi:10.1353/dem.2003.0016
20.
LynchS. M.TaylorM. G. (2016). Trajectory models for aging research. In GeorgeLinda K.FerraroKenneth F. (Eds.), Handbook of aging and the social sciences (pp. 23-51). San Diego, CA: Academic Press. doi:10.1016/b978-0-12-417235-7.00002-0
21.
MantonK. G.GuX. (2001). Changes in the prevalence of chronic disability in the United States black and nonblack population above age 65 from 1982 to 1999. Proceedings of the National Academy of Sciences of the United States of America, 98, 6354-6359. doi:10.1073/pnas.111152298
22.
MartinL. G.FreedmanV. A.SchoeniR. F.AndreskiP. M. (2010). Trends in disability and related chronic conditions among people ages fifty to sixty-four. Health Affairs, 29, 725-731. doi:10.1377/hlthaff.2008.0746
NaginD. S.TremblayR. (2005). Developmental trajectory groups: Fact or a useful statistical fiction?Criminology, 43, 873-904. doi:10.1111/j.1745-9125.2005.00026.x
25.
SchoeniR. F.FreedmanV. A.MartinL. G. (2008). Why is late-life disability declining?Milbank Quarterly, 86, 47-89. doi:10.1111/j.1468-0009.2007.00513.x
26.
SchoeniR. F.FreedmanV. A.WallaceR. B. (2001). Persistent, consistent, widespread, and robust? another look at recent trends in old-age disability. The Journals of Gerontology, Series B: Psychological Sciences & Social Sciences, 56, S206-S218. doi:10.1093/geronb/56.4.S206
27.
SeemanT. E.MerkinS. S.CrimminsE. M.KarlamanglaA. S. (2010). Disability trends among older Americans: National health and nutrition examination surveys, 1988-1994 and 1999-2004. American Journal of Public Health, 100, 100-107. doi:10.2105/AJPH.2008.157388
28.
TaylorM. G.LynchS. M. (2011). Cohort differences and chronic disease profiles of differential disability trajectories. The Journals of Gerontology, Series B, Psychological Sciences & Social Sciences, 66, 729-738. doi:10.1093/geronb/gbr104
29.
WarnerD. F.BrownT. H. (2011). Understanding how race/ethnicity and gender define age-trajectories of disability: An intersectionality approach. Social Science & Medicine, 72, 1236-1248. doi:10.1016/j.socscimed.2011.02.034
30.
World Health Organization. (1977). Manual of the 34 international classification of diseases, injuries, and causes of death, based on the recommendations of the ninth revision conference, 1975, and adopted by the twenty-ninth world health assembly. Geneva, Switzerland: Author.
31.
YangY. (2008). Trends in U.S. adult chronic disease mortality, 1960-1999: Age, period, and cohort variations. Demography, 45, 387-416. doi:10.1353/dem.0.0000
32.
YangY.LeeL. C. (2009). Sex and race disparities in health: Cohort variations in life course patterns. Social Forces, 87, 2093-2124. doi:10.1353/sof.0.0183
33.
ZimmerZ.MartinL. G.NaginD. S.JonesB. L. (2012). Modeling disability trajectories and mortality of the oldest-old in china. Demography, 49, 291-314. doi:10.1007/s13524-011-0075-7
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