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Teresa E. Seeman, PhD, Sharon S. Merkin, PhD, Eileen M. Crimmins, PhD and Arun S. Karlamangla, MD, PhD

Teresa E. Seeman, Sharon S. Merkin, and Arun S. Karlamangla are with the Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles. Eileen M. Crimmins is with the Andrus Gerontology Center, University of Southern California, Los Angeles.

Correspondence: Correspondence should be sent to: Teresa E. Seeman, UCLA Division of Geriatrics, 10945 Le Conte Ave, Los Angeles, CA 90095 (e-mail: tseeman{at}mednet.ucla.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We investigated trends in disability among older Americans from 1988 through 2004 to test the hypothesis that more recent cohorts show increased burdens of disability.

Methods. We used data from 2 National Health and Nutrition Examination Surveys (1988–1994 and 1999–2004) to assess time trends in basic activities of daily living, instrumental activities, mobility, and functional limitations for adults aged 60 years and older. We assessed whether changes could be explained by sociodemographic, body weight, or behavioral factors.

Results. With the exception of functional limitations, significant increases in each type of disability were seen over time among respondents aged 60 to 69 years, independent of sociodemographic characteristics, health status, relative weight, and health behaviors. Significantly greater increases occurred among non-Whites and persons who were obese or overweight (2 of the fastest-growing subgroups within this population). We detected no significant trends among respondents aged 70 to 79 years; in the oldest group (aged 80 years), time trends suggested lower prevalence of functional limitations among more recent cohorts.

Conclusions. Our results have significant and sobering implications: older Americans face increased disability, and society faces increased costs to meet the health care needs of these disabled Americans.

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