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Living Long & Well in the 21st Century: Strategic Directions for Research on Aging

Understanding of Disability Trends Provides Insights for Effective Interventions

Disability rates among older Americans—the numbers of people unable to carry out, to specified levels, essential activities of daily living—have declined in recent decades, suggesting an improvement in health and function. Activities of daily living assessed in these studies generally include eating, dressing, bathing, toileting, and transferring from a lying down to a sitting or standing position. Researchers sometimes also examine “instrumental activities of daily living” like shopping or using the telephone.

The disability decline has been demonstrated in a number of studies, including the most recent U.S. National Long-Term Care Survey. This analysis revealed that the prevalence of chronic disability has dropped significantly from 1982 to the present. The continuing decline in disability among older people is one of the most encouraging and important trends in the aging of the American population. However, this trend may be threatened by rising rates of obesity and sedentary lifestyles in children and younger adults—both risk factors for late life disability.

Continued research on the causes of disability will inform the development and implementation of effective medical and behavioral interventions as well as public health programs to promote their use. For example, the Department of Health and Human Services uses health and disability trend information to create programs such as HealthierUS, a national effort to improve people’s lives, prevent and reduce the costs of disease, and promote community health and wellness through physical activity, healthy diet, preventive screening, and cessation of high health risk behaviors such as cigarette smoking.