. "6 Research and Development Toward Improved Measures of Late-Life Disability." Improving the Measurement of Late-Life Disability in Population Surveys: Beyond ADLs and IADLs: Summary of a Workshop. Washington, DC: The National Academies Press, 2009.
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Improving the Measurement of Late-Life Disability in Population Surveys: Beyond ADLs and IADLs - Summary of a Workshop
individuals who become disabled, say by a hip fracture or other injury or any hospitalization, regain the full array of their predisability function.
The second area is the use of vignettes, a promising method that calls for further research and experimentation. The focus to date has been on cross-national comparisons. Can vignettes be used within the United States to better understand the differences in disability among different ethnic or racial groups or between genders? For some of the disability patterns and disparities described in the workshop, Gill noted that the African American population has a disability profile that mirrors the white population, but for 10 years younger. Could some of that difference be understood through the use of vignettes in identifying the different pathways to disability and distinct populations in the United States?
Arthur van Soest highlighted four areas. First he asked: What is the definition of late life? This workshop is about late-life disability. One can distinguish between the older old (say, 70 years and older) and the younger old (say, ages 50–70). There are differences in the issues concerning these two groups. For the older group, such things as home adjustments, devices, informal and formal care, and neighborhood characteristics seem to be most relevant. For the younger group, the relationship between work and disability seems crucial, including working conditions, employer attitudes and accommodations, job characteristics, stressful and physically demanding work, and stress due to unemployment.
Van Soest noted that most presentations during the workshop focused on the older group, but the younger group also deserves attention for two reasons. First, a substantial percentage in this group already suffers from disabilities; second, health and disability, as well as employment characteristics, at younger ages, are predictive of disabilities at an older age. So the issues may be different for the two groups, but both are worth studying. One of the implications is that longitudinal data are needed to follow people over a long period of time. He noted that the Health and Retirement Study is now reaching the stage at which one can start to study these long-term effects with good longitudinal data.
Second, van Soest noted that health is well known to be related to socioeconomic status, and the same is true for disability. Whichever method is used to measure disability, the data will show a negative association between prevalence of disability and socioeconomic status—education level and income or wealth. Determining the causal mechanisms that may lead to this association is an important research question.
He said that the workshop pointed to several potential mechanisms that may explain a causal effect of socioeconomic status on disability prevalence: working conditions (physically demanding work, stress), differences in