Little is understood about the role of technologies (e.g. assistive technologies such as mobility aids and technologies that are widely available such as microwaves and automated banking machines), home modifications (e.g. installation of ramps, rails, walk-in showers, etc.) and behavioral factors (e.g. only walking around outside with a companion to hold onto) in explaining recent declines in disability observed in national longitudinal surveys of elderly. We propose to conduct a pilot survey of community-dwelling elderly using four different measures of disability to understand whether use of technologies and home and behavioral modifications affects self-reported disability. The survey methods we propose to use to measure disability include existing survey questions about difficulty conducting Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (lADLs) with and without help, anchoring vignettes, a novel technique in survey research that will allow us to understand whether survey respondents have different propensities to report disability based on their use of technologies and modifications, and objective physical assessments. The goals of the study are to 1) compare the four methods to ascertain whether they provide different estimates of disability in the elderly population, 2) examine the extent to which use of technologies and modifications may explain differences in disability estimates between the different methods, and 3) use the results of the pilot study to design a national survey or adjuncts to an existing survey to collect valid summary measures of disability. This research is critical for researchers, and for policy-makers who seek to understand why disability is changing and what implications those changes will have for longevity and medical spending.
