Education and disability trends of older Americans, 2000-2014.
Trends in disability among older Americans has declined since the 1980s. The study examines whether the trend continues to decline and whether educational disparities exist in the prevalence of functional limitations.



I used the 2000-2014 National Health Interview Survey and included adults aged ≥65 years. Functional limitations was measured by three outcomes: the need for help with activities of daily living (ADLs) or instrumental activities of daily living (IADLs) and physical function limitations. I used a set of logistic models to estimate the average annual change rate of functional limitations. I examined whether the annual rate of change differed by education, age group and sex.



During 2000-2014, the annual increase rate of ADL limitations was 1.7% (P < 0.001) and was 2.0% (P < 0.001) for physical function limitations; IADL limitation did not change significantly. All subgroups experienced an increase in ADL and physical function limitations except for adults with a more than high school education. The lower-educated group had a higher proportion and a higher annual rate of increase in all outcomes. Increasing trends in chronic conditions may contribute to the increasing trend in functional limitations.



The study highlighted a large educational disparity in late-life disability among older Americans.
National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road NE, MS A19, Atlanta, GA30329, USA.
Yuping
Y
Tsai
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
education; functional limitations; older adults
Health Serv Res. 1999 Apr;34(1 Pt 2):241-54
10199672
Am J Public Health. 2005 Nov;95(11):2065-70
16254235
Am J Public Health. 1998 Oct;88(10):1457-62
9772844
Proc Natl Acad Sci U S A. 2001 May 22;98(11):6354-9
11344275
N Engl J Med. 2006 Aug 17;355(7):695-703
16914705
Demography. 1999 Nov;36(4):461-73
10604075
Milbank Q. 2005;83(3):365-95
16201997
J Gerontol B Psychol Sci Soc Sci. 2000 Sep;55(5):S298-307
10985301
Am J Public Health. 1995 Dec;85(12):1623-9
7503335
J Cancer Epidemiol. 2011;2011:107497
22496688
Annu Rev Public Health. 2004;25:79-98
15015913
Demography. 2007 Aug;44(3):459-77
17913006
Proc Natl Acad Sci U S A. 1997 Mar 18;94(6):2593-8
9122240
Disabil Health J. 2014 Jan;7(1 Suppl):S4-14
24456683
Demography. 2010;47 Suppl:S17-40
21302428
Proc Natl Acad Sci U S A. 2006 Nov 28;103(48):18374-9
17101963
Demography. 2013 Apr;50(2):661-71
23104207
JAMA. 2000 Dec 20;284(23):3022-7
11122589
J Gerontol B Psychol Sci Soc Sci. 1997 Mar;52(2):S59-71
9060986
Am J Public Health. 2010 Jan;100(1):100-7
19910350
Am J Public Health. 2001 Feb;91(2):277-83
11211638
Health Aff (Millwood). 2010 Apr;29(4):725-31
20368601
J Health Econ. 2013 May;32(3):647-58
23477686
Health Aff (Millwood). 2001 Nov-Dec;20(6):11-27
11816649
Milbank Q. 2008 Mar;86(1):47-89
18307477