title: Recent trends in chronic disease, impairment and disability among older adults in the United States.
abstract: BACKGROUND
  To examine concurrent prevalence trends of chronic disease, impairment and disability among older adults.
  
  
  METHODS
  We analyzed the 1998, 2004 and 2008 waves of the Health and Retirement Study, a nationally representative survey of older adults in the United States, and included 31,568 community dwelling adults aged 65 and over. Measurements include: prevalence of chronic diseases including hypertension, heart disease, stroke, diabetes, cancer, chronic lung disease and arthritis; prevalence of impairments, including impairments of cognition, vision, hearing, mobility, and urinary incontinence; prevalence of disability, including activities of daily living (ADLs) and instrumental activities of daily living (IADLs).
  
  
  RESULTS
  The proportion of older adults reporting no chronic disease decreased from 13.1% (95% Confidence Interval [CI], 12.4%-13.8%) in 1998 to 7.8% (95% CI, 7.2%-8.4%) in 2008, whereas the proportion reporting 1 or more chronic diseases increased from 86.9% (95% CI, 86.2%-89.6%) in 1998 to 92.2% (95% CI, 91.6%-92.8%) in 2008. In addition, the proportion reporting 4 or more diseases increased from 11.7% (95% CI, 11.0%-12.4%) in 1998 to 17.4% (95% CI, 16.6%-18.2%) in 2008. The proportion of older adults reporting no impairments was 47.3% (95% CI, 46.3%-48.4%) in 1998 and 44.4% (95% CI, 43.3%-45.5%) in 2008, whereas the proportion of respondents reporting 3 or more was 7.2% (95% CI, 6.7%-7.7%) in 1998 and 7.3% (95% CI, 6.8%-7.9%) in 2008. The proportion of older adults reporting any ADL or IADL disability was 26.3% (95% CI, 25.4%-27.2%) in 1998 and 25.4% (95% CI, 24.5%-26.3%) in 2008.
  
  
  CONCLUSIONS
  Multiple chronic disease is increasingly prevalent among older U.S. adults, whereas the prevalence of impairment and disability, while substantial, remain stable.
authors.affiliation: Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, NY, USA. william.hung@mssm.edu
authors.forename: William W
authors.initials: WW
authors.lastname: Hung
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Ross
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Boockvar
authors.forename: Albert L
authors.initials: AL
authors.lastname: Siu
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006306:Health Surveys / Q000639:trends*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D014481:United States / Q000453:epidemiology; D019987:Persons with Visual Disabilities / Q000523:psychology