Are Functional and Activity Limitations Becoming More Prevalent among 55 to 69-Year-Olds in the United States?

Hwajung Choi,Robert F Schoeni,Linda G Martin,Ying-Mei Feng

doi:10.1371/journal.pone.0164565

Abstract

ObjectivesThis study examines changes in functional and activity limitations 1998–2012 for individuals 55–69.MethodsLogistic models are used to estimate trends in limitations in vision, hearing, physical and cognitive functioning, IADLs, and ADLs. Additional models assess the extent to which trends are associated with and differ by education, smoking, and BMI.ResultsChanges in prevalence of limitations in vision, hearing, cognitive functioning, and ADLs are not statistically significant. Limitations in physical functioning declined by 0.37% per year. IADL limitations increased by 1.33% per year, but most of the increase occurred between 2008 and 2010/2012, and are associated with economic hardship during the Great Recession. Increases in education are especially beneficially associated with trends in limitations, but reductions in smoking also appear to be advantageous for some outcomes. Increases in BMI are associated with trends in physical functioning, IADL, and ADL limitation.DiscussionFor Americans 55–69, functional and activity limitations were largely unchanged 1998–2012. Our results suggest that if educational attainment had not increased, most functional and activity limitations potentially could have worsened substantially. Future change in educational attainment is not expected to be so positive. Continued monitoring of trends in activity limitations might well include greater focus on the explanatory roles of environmental factors, including economic circumstances.

Highlights

The rapid decline in the prevalence of functional and activity limitations among the 65 and over population in the 1980s and 1990s is well documented [1]
Our results suggest that if educational attainment had not increased, most functional and activity limitations potentially could have worsened substantially
This study focuses on the U.S population ages 55 to 69 and uses national data from 1998 to 2012 from the Health and Retirement Study (HRS) to address three questions

Summary

Introduction

The rapid decline in the prevalence of functional and activity limitations among the 65 and over population in the 1980s and 1990s is well documented [1]. There is growing concern that the prevalence of functional and activity limitations at pre-retirement ages may even have increased [4,5,6,7,8], a troubling trend for these cohorts but for the future of health care and related spending. A recent National Research Council report (2015) [9] and Bound and colleagues (2015) [10] highlighted growing socioeconomic differentials in life expectancy in the United States. Analyzing trends in the prevalence of activity limitations, Schoeni and colleagues (2005, 2009) [12, 13] found increasing disparities by education and income for the 70 and over population from 1982 to 2002

Objectives

Results

Conclusion