In this issue of THE JOURNAL, Freedman and colleagues1 present
encouraging evidence from a number of sources that disability in seniors is
decreasing. The authors identified and reviewed 16 articles based on 8 surveys
that assessed US trends in the prevalence of self-rated older adult disability
and physical, cognitive, and sensory limitations among older adults beginning
in 1982 through 1999. Of the studies assessed as having at least fair quality,
surveys showed consistent declines in instrumental activities of daily living
(IADLs) and in functional limitations. These findings are conservatively presented
and all are consistent with the single best study, the report by Manton and
Gu,2 which presents the most recent data, has
the most detailed end points, surveys the most representative sample of the
US population, and shows the most striking findings. Manton and Gu studied
trends in disability in the National Long Term Care Surveys (NLTCS) of 1982,
1989, 1994, and 1999 of the Medicare-eligible population aged 65 years and
older, which include both institutionalized and noninstitutionalized individuals.
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