Many Americans Suffer High Rate of Disability in Final Years

Posted on Jul 26, 2013

Americans are living longer, but their lives may not be healthier. A recent study from researchers at the University of California, San Francisco (UCSF), found that most Americans suffer from disabilities and mobility problems in their final years.

The UCSF scientists assessed 15 years of data from the National Health and Retirement Study in order to determine disability rates in the final two years of life. They reviewed interviews with more than 8,200 adults over the age of 50 who died between 1995 and 2010.

The researchers defined disability as any physical health problem that caused the person to need assistance with one or more activity of daily life. Activities of daily life included being able to bathe, dress, use the toilet or prepare food on one’s own. A person was considered severely disabled if he or she needed assistance with three or more activities of daily life. Cognitive and mental disabilities were not included in the study.

Nearly 28 percent of those interviewed had a disability in the last two years of life. About 12 percent had a severe disability. However, disability rate rose with age. Only 15 percent of those who were age 50 to 69 at the time of death were disabled at the time of death. Half of those who died after reaching age 90 had disabilities.

Women tended to have longer periods of disability than men. This is partly due to the fact that women tend to live longer and are more prone to depression, arthritis, and osteoporosis. But, women are also more likely to live on a fixed income – a factor associated with higher disability rates.

Mobility issues were more of a concern.  Sixty-nine percent of adults participating in the study were unable to walk more than a few blocks in their final years of life. Forty-five percent had difficulty walking one block. About half were unable to climb a single flight of stairs.

Mobility problems and disabilities can affect quality of life. However, those who are active in their communities despite disability report more satisfaction in their final years.

We can slow down or delay disability, but we may not be able to avoid it. This study will help social service and government agencies estimate disability rates, so they can plan for the needs of aging baby boomers, including funding for accessible housing, accessible transportation, and benefit programs like Social Security Income (SSI) and Social Security Disability Insurance (SSDI).

The complete study was published in the July 8, 2013 issue of JAMA Internal Medicine.

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