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Administration on Aging (AoA)

A Profile of Older Americans: 2012

Disability and Activity Limitations

Some type of disability (i.e., difficulty in hearing, vision, cognition, ambulation, self-care, or independent living) was reported by 35% of men and 38% of women age 65+ in 2011. Some of these disabilities may be relatively minor but others cause people to require assistance to meet important personal needs. There is a strong relationship between disability status and reported health status. Presence of a severe disability is also associated with lower income levels and educational attainment.

Using limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) to measure disability, 28% of community-resident Medicare beneficiaries age 65+ reported difficulty in performing one or more ADL and an additional 12% reported difficulty with one or more IADL. By contrast, 92% of institutionalized Medicare beneficiaries had difficulties with one or more ADLs and 76% of them had difficulty with three or more ADLs. [ADLs include bathing, dressing, eating, and getting around the house. IADLs include preparing meals, shopping, managing money, using the telephone, doing housework, and taking medication.] Limitations in activities because of chronic conditions increase with age. As shown in Figure 9, the rate of limitations in activities among noninstitutionalized persons 85 and older are much higher than those for persons 65-74.

Figure 9:
Figure 9 is a chart of the percent of older persons with limitations in activities of daily living by age group.  For most activities, the two younger groups which are under 85 years old show only 2%-28% who are limited.  The 85 and over group show much higher rates of activity limitations, ranging from 6% for eating to 46% for walking.

Except where noted, the figures above are taken from surveys of the noninstitutionalized elderly. Although nursing homes are being increasingly used for short-stay post-acute care, about 1.3 million elderly are in nursing homes (more than half are age 85 and over). These individuals often need care with their ADLs and/or have severe cognitive impairment due to Alzheimer's disease or other dementias.

(Based on online data from the U.S. Census Bureau’s American Community Survey. The Centers for Medicare and Medicaid Services’ Medicare Current Beneficiary Survey. The National Center for Health Statistics, including the NCHS Health Data Interactive data warehouse.)

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Last Modified: 8/25/2014