FIGURE 4-5  Trend in disability rate for ages 65+ in three national surveys. SOURCE: Data as reported in the MCBS, the NLTCS, and the NHIS.

of declining ADL/IADL disability in older persons ended in the beginning of the last decade.

When it comes to less severe forms of disability, such as limitations in movement and the like, a different picture may be emerging. Using data from NHANES and NHIS, Martin, Schoeni, and Andreski (2010) found that two-thirds of the elderly had a limitation in at least one of the nine physical functions listed earlier. From 1997 to 2008 this prevalence was stable for males and increased gradually (1 percent per year) for females. The authors found, as did others who work in this area, that the effect of education was important and that the increase in educational attainment for the elderly during this time mitigated what would otherwise have been an increase in the prevalence of these limitations.


The leveling off of disability decline in the older population, combined with apparent increases in disability among the working age population, complicates the forecasting of disability and related health care costs. In addition, other sources of uncertainty deserve mention. On the one hand, things could get worse than expected. Certain secular changes, such as the dramatic increase in overweight and obesity among the nonelderly and the

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