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The Burden of Functional Disabilities for Middle-Aged and Older Adults in the United States

  • Ryan McGrath
  • S. Al Snih
  • K. Markides
  • K. Hackney
  • R. Bailey
  • M. Peterson
Article

Abstract

Objectives

Understanding the role of functional capacity on longevity is important as the population in the United States ages. The purpose of this study was to determine the burden of instrumental activities of daily living (IADL) and activities of daily living (ADL) disabilities for a nationally-representative sample of middle-aged and older adults in the United States.

Design

Longitudinal-Panel.

Setting

Core interviews were often performed in person or over the telephone.

Participants

A sub-sample of 31,055 participants aged at least 50 years from the 1998–2014 waves of the Health and Retirement Study who reported having a functional disability were included.

Measurements

Ability to perform IADLs and ADLs were self-reported at each wave. The National Death Index was used to ascertain date of death. The number of years of life that were lost (YLLs) and years lived with a disability (YLDs) were summed for the calculation of disability-adjusted life years (DALYs). Sampling weights were used in the analyses to make the DALYs nationally-representative. The results for YLLs, YLDs, and DALYs are reported in thousands.

Results

Of the participants included, 14,990 had an IADL disability and 13,136 had an ADL disability. Men and women with an IADL disability had 236,037 and 233,772 DALYs, respectively; whereas, there were 178,594 DALYs for males and 253,630 DALYs for females with an ADL disability. Collectively, there were 469,809 years of healthy life lost from IADL impairments, and 432,224 years of healthy life lost from ADL limitations.

Conclusions

These findings should be used to inform healthcare providers and guide interventions aiming to preserve the functional capacity of aging adults. Prioritizing health-related resources for mitigating the burden of functional disabilities may help aging adults increase their quality of life and life expectancy over time.

Key words

Geriatrics morbidity mortality rehabilitation 

Supplementary material

12603_2018_1133_MOESM1_ESM.docx (21 kb)
Appendix 1. Results of the Disability-Adjusted Life Years for Functional Disabilities by Sex.

References

  1. 1.
    Millan-Calenti JC, Tubío J, Pita-Fernández S et al. Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Arch Gerontol Geriatr. 2010;50:306–10.CrossRefPubMedGoogle Scholar
  2. 2.
    Majer IM, Nusselder WJ, Mackenbach JP, Klijs B, van Baal PH). Mortality risk associated with disability: a population-based record linkage study. Am J Public Health. 2011;101:e9–e15.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Dunlay SM, Manemann SM, Chamberlain AM et al. Activities of daily living and outcomes in heart failure. Circ Heart Fail. 2015;8:261–7.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Liang Y, Welmer A-K, Möller J, Qiu C. Trends in disability of instrumental activities of daily living among older Chinese adults, 1997-2006: population based study. BMJ Open. 2017;7:e016996.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Stevens AC. Adults with one or more functional disabilities—United States, 2011–2014. MMWR Morb Mortal Wkly Rep. 2016;65:1021–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Mokdad AH, Ballestros K, Echko M et al). The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states. JAMA. 2018;319:1444–72.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Global Burden of Disease. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study. Lancet. 2017;390:1211-59.Google Scholar
  8. 8.
    Grosse SD, Lollar DJ, Campbell VA, Chamie M. Disability and disability-adjusted life years: not the same. Public Health Rep. 2009;124:197–202.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Sonnega A, Faul JD, Ofstedal MB, Langa KM, Phillips JW, Weir DR. Cohort profile: the health and retirement study (HRS). Int J Epidemiol. 2014;43:576–85.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Health and Retirement Study. HRS Data Book. https://hrs.isr.umich.edu/about/databook. Accessed 22 August 2018.Google Scholar
  11. 11.
    World Health Organization. Metrics: Disability-Adjusted Life Year (DALY). http://www.who.int/healthinfo/global_burden_disease/metrics_daly/en/. Accessed 22 August 2018.Google Scholar
  12. 12.
    Struijk EA, May AM, Beulens JW et al. Development of methodology for disabilityadjusted life years (DALYs) calculation based on real-life data. PLoS One. 2013;8:e74294.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    United States Social Security Administration. Period Life Table, 2014. https://www. ssa.gov/oact/STATS/table4c6_2014.html. Accessed 22 August 2018.Google Scholar
  14. 14.
    Petersen RC, Roberts RO, Knopman DS et al. Prevalence of mild cognitive impairment is higher in men The Mayo Clinic Study of Aging. Neurology. 2010;75:889–97.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Hubbard RE. Sex differences in frailty. Interdiscip Top Gerontol Geriatr. 2015;41:41–53.PubMedGoogle Scholar
  16. 16.
    Fong JH, Mitchell OS, Koh BS. Disaggregating activities of daily living limitations for predicting nursing home admission. Health Serv Res. 2015;50:560–78.CrossRefPubMedGoogle Scholar
  17. 17.
    Mlinac ME, Feng MC. Assessment of activities of daily living, self-care, and independence. Arch Clin Neuropsychol. 2016;31:506–16.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Ryan McGrath
    • 1
    • 6
  • S. Al Snih
    • 2
  • K. Markides
    • 3
  • K. Hackney
    • 1
  • R. Bailey
    • 4
  • M. Peterson
    • 5
  1. 1.Department of Health, Nutrition, and Exercise SciencesNorth Dakota State UniversityFargoUSA
  2. 2.Division of Rehabilitation SciencesUniversity of Texas Medical BranchGalvestonUSA
  3. 3.Department of Preventive Medicine and Community HealthUniversity of Texas Medical BranchGalvestonUSA
  4. 4.Brown School of Social WorkWashington University in St. LouisSt. LouisUSA
  5. 5.Department of Physical Medicine and RehabilitationUniversity of MichiganAnn ArborUSA
  6. 6.North Dakota State University, NDSU Dept. 2620FargoUSA

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