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Behavioral adaptation and late-life disability: A new spectrum for assessing public health impacts

Author

Listed:
  • Freedman, V.A.
  • Kasper, J.D.
  • Spillman, B.C.
  • Agree, E.M.
  • Mor, V.
  • Wallace, R.B.
  • Wolf, D.A.

Abstract

Objectives. To inform public health efforts to promote independent functioning among older adults, we have provided new national estimates of late-life disability that explicitly recognize behavioral adaptations. Methods. We analyzed the 2011 National Health and Aging Trends Study, a study of Medicare enrollees aged 65 years and older (n = 8077). For 7 mobility and self-care activities we identified 5 hierarchical stages-fully able, successful accommodation with devices, activity reduction, difficulty despite accommodations, and receipt of help-and explored disparities and associations with quality of life measures. Results. Among older adults, 31% were fully able to complete self-care and mobility activities. The remaining groups successfully accommodated with devices (25%), reduced their activities (6%), reported difficulty despite accommodations (18%), or received help (21%). With successive stages, physical and cognitive capacity decreased and symptoms and multimorbidity increased. Successful accommodation was associated with maintaining participation in valued activities and high well-being, but substantial disparities by race, ethnicity, and income existed. Conclusions. Increased public health attention to behavioral adaptations to functional change can promote independence for older adults and may enhance quality of life.

Suggested Citation

  • Freedman, V.A. & Kasper, J.D. & Spillman, B.C. & Agree, E.M. & Mor, V. & Wallace, R.B. & Wolf, D.A., 2014. "Behavioral adaptation and late-life disability: A new spectrum for assessing public health impacts," American Journal of Public Health, American Public Health Association, vol. 104(2), pages 88-94.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2013.301687_1
    DOI: 10.2105/AJPH.2013.301687
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    Cited by:

    1. Young Ko & Wonjung Noh, 2021. "A Scoping Review of Homebound Older People: Definition, Measurement and Determinants," IJERPH, MDPI, vol. 18(8), pages 1-17, April.
    2. Vicki A. Freedman & Judith D. Kasper & Brenda C. Spillman, 2017. "Successful Aging Through Successful Accommodation With Assistive Devices," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 72(2), pages 300-309.
    3. Meghan Jenkins Morales & Stephanie A Robert & Deborah Carr, 0. "Black–White Disparities in Moves to Assisted Living and Nursing Homes Among Older Medicare Beneficiaries," Journals of Gerontology: Series B, Gerontological Society of America, vol. 75(9), pages 1972-1982.
    4. Merja Rantakokko & Erja Portegijs & Anne Viljanen & Susanne Iwarsson & Taina Rantanen, 2016. "Mobility Modification Alleviates Environmental Influence on Incident Mobility Difficulty among Community-Dwelling Older People: A Two-Year Follow-Up Study," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-10, April.
    5. Montez, Jennifer Karas & Hayward, Mark D. & Wolf, Douglas A., 2017. "Do U.S. states' socioeconomic and policy contexts shape adult disability?," Social Science & Medicine, Elsevier, vol. 178(C), pages 115-126.
    6. Agree Emily M. & Wolf Douglas A., 2018. "Disability Measurement in the Health and Retirement Study," Forum for Health Economics & Policy, De Gruyter, vol. 21(1), pages 1-14, June.

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