Over the past decade, a consensus has emerged that disability prevalence rates have declined among older Americans. Several studies suggest that the prevalence of severe cognitive functioning also may be declining among older Americans. If such declines continue into the future, their effect on the nation's health and economic well-being could be incredibly far-reaching, with potentially more older Americans able to work longer and relatively fewer needing medical and long-term care. Yet the consequences of recent trends in late-life health remain open to debate in part because the direction of future trends remains illusive. Whether these improvements have been experienced widely is also still unclear and the explanations for the declines remain a scientific mystery. The goal of this project is to update and expand our understanding of trends in late-life health. We define health broadly to include chronic conditions and impairments; physical, cognitive, and sensory limitations; and disability. Drawing upon new data from the National Health Interview Survey (NHIS), the Health and Retirement Study (HRS) and its sister survey the Asset and Health Dynamics of the Oldest Old (AHEAD) study, and the Panel Survey Study of Income Dynamics (PSID), the latter a completely untapped source on this topic, we will:
Aim I. Update trends in late-life health into the 21st Century. We will focus primarily on trends in the prevalence of late-life health measures but where possible also investigate the underlying incidence, recovery, and mortality processes driving prevalence trends.
Aim II. Investigate the extent of disparities in health trends by race/ethnicity, sex, marital status, nativity, and socioeconomic status. By answering whether the gaps in prevalence are narrowing or widening, we will provide insight into future directions in overall trends.
Aim III. Investigate the role of experiences earlier in life as a possible explanation for overall trends. In particular, we will focus on changes in early and midlife factors as possible influences driving improvements in late-life health.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG021516-04
Application #
6871326
Study Section
Social Sciences, Nursing, Epidemiology and Methods 4 (SNEM)
Program Officer
Patmios, Georgeanne E
Project Start
2003-05-01
Project End
2008-04-30
Budget Start
2006-05-15
Budget End
2008-04-30
Support Year
4
Fiscal Year
2006
Total Cost
$296,129
Indirect Cost
Name
University of Medicine & Dentistry of NJ
Department
Miscellaneous
Type
Schools of Public Health
DUNS #
150968910
City
New Brunswick
State
NJ
Country
United States
Zip Code
08903
Martin, Linda G; Freedman, Vicki A; Schoeni, Robert F et al. (2010) Trends in disability and related chronic conditions among people ages fifty to sixty-four. Health Aff (Millwood) 29:725-31
Martin, Linda G; Freedman, Vicki A; Schoeni, Robert F et al. (2009) Health and functioning among baby boomers approaching 60. J Gerontol B Psychol Sci Soc Sci 64:369-77
Martin, Linda G (2009) Interventions to Improve Late Life. Popul Dev Rev 35:331-340
Freedman, Vicki A; Martin, Linda G; Schoeni, Robert F et al. (2008) Declines in late-life disability: the role of early- and mid-life factors. Soc Sci Med 66:1588-602
Iezzoni, Lisa I; Freedman, Vicki A (2008) Turning the disability tide: the importance of definitions. JAMA 299:332-4
Schoeni, Robert F; Freedman, Vicki A; Martin, Linda G (2008) Why is late-life disability declining? Milbank Q 86:47-89
Freedman, Vicki A; Schoeni, Robert F; Martin, Linda G et al. (2007) Chronic conditions and the decline in late-life disability. Demography 44:459-77
Martin, Linda G; Schoeni, Robert F; Freedman, Vicki A et al. (2007) Feeling better? Trends in general health status. J Gerontol B Psychol Sci Soc Sci 62:S11-21
Freedman, Vicki A; Agree, Emily M; Martin, Linda G et al. (2006) Trends in the use of assistive technology and personal care for late-life disability, 1992-2001. Gerontologist 46:124-7
Schoeni, Robert F; Martin, Linda G; Andreski, Patricia M et al. (2005) Persistent and growing socioeconomic disparities in disability among the elderly: 1982-2002. Am J Public Health 95:2065-70