Basic ADL Disability and Functional Limitation Rates Among Older Americans From 2000-2005

The End of the Decline?

There was a significant increase in disabilities related to basic activities of daily living (ADL) in the older adult population from 2000 to 2005; the findings reverse a decrease in disability rates over the previous two decades.

This study examined trends in ADL disabilities and functional limitations (e.g., difficulty reaching or moving) using data from the American Community Survey (ACS). ACS is the largest, nationally representative survey of older adults living among the general population. The sample size of ACS ranges from roughly 500,000 to almost 2 million households.

In addition to ACS, the authors considered data from the National Nursing Home Survey (NNHS). Based on data from the NNHS, the authors estimated that all individuals in nursing homes had basic ADL disabilities and functional limitations. NNHS showed a decline in nursing home residents from 1999-2004. The authors assumed that the nursing home population declined at the same rate for both genders; the authors calculated each year's disability rate for all older adults (in and out of nursing homes).

This study examined ADL disabilities and functional limitations separately. Separate analyses enabled comparisons between the two trends.

Key Findings:

  • Basic ADL disabilities showed a 9 percent relative increase from 2000 to 2005.
  • There were no significant changes in functional limitations among older adults.

Analyses of data from two surveys of older adults found a reversal in the decline of basic disabilities that occurred during the 1980s and 1990s. The findings of this study conflict with previous research that indicated a decline in ADL disabilities from 1999-2004. The authors consider possible explanations for the discrepancy.