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A Profile of Older Americans: 2003

Disability and Activity Limitations

In 1997, more than half of the older population (54.5%) reported having at least one disability of some type (physical or nonphysical). Some of these disabilities may be relatively minor but others cause people to require assistance to meet important personal needs. Over a third (37.7%) reported at least one severe disability. The percentages with disabilities increase sharply with age (Figure 8). Disability takes a much heavier toll on the very old. Almost three-fourths (73.6%) of those aged 80+ report at least one disability. Over half (57.6%) of those aged 80+ had one or more severe disabilities and 34.9% of the 80+ population reported needing assistance as a result of disability. There is a strong relationship between disability status and reported health status. Among those 65+ with a severe disability, 68.0% reported their health as fair or poor. Among the 65+ persons who reported no disability, only 10.5% reported their health as fair or poor. Presence of a severe disability is also associated with lower income levels and educational attainment.

Figure 8: Percent With Disabilities, By Age: 1997

Figure 8: Percent With Disabilities, By Age: 1997

In another study which focused on the ability to perform specific activities of daily living (ADLs), over 27.3% of community-resident Medicare beneficiaries over age 65 in 1999 had difficulty in performing one or more ADLs and an additional 13.0% reported difficulties with instrumental activities of daily living (IADLs). By contrast, 93.3% of institutionalized Medicare beneficiaries had difficulties with one or more ADLs and 76.3% 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 on activities because of chronic conditions increase with age. Among those 65-74 years old, 19.9 percent had difficulties with ADLs. In contrast, over half (52.5%) of these 85 years and older had difficulties with ADLs.

It should be noted that (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 1.6 million elderly are in nursing homes (about half are age 85 and over). These individuals often have high needs for care with their ADLs and/or have severe cognitive impairment, due to Alzheimer's disease or other dementias.

(Sources: Current Population Reports, "Americans with Disabilities, 1997" P70-73, February 2001 and related Internet data; Internet releases of the Census Bureau and the National Center on Health Statistics)

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