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Better Health In Earlier Years Needed To Avoid Disability

January 4, 2010
According to a study led by researchers at the University of Toronto and the University of California, Berkeley, the steady decline since the 1980s of disability rates among older adults may have ended, a trend that could seriously impact the quality of life of seniors in the coming decades if it continues. "The combination of increasing disability rates plus a growing population of older adults emphasizes the importance of prevention of the many chronic conditions giving rise to disability in the first place," said the study's lead author, Esme Fuller-Thomson, professor of social work at the University of Toronto. "There is evidence, for example, that the doubling of obesity rates over the last three decades may be linked to rising disability in older people, yet the obesity problem is largely preventable." The study, appearing in the December issue of the Journals of Gerontology, reflects a 9 percent increase over five years in seniors not living in a nursing home setting reporting difficulty in basic activities of daily living, like dressing, bathing and in-home mobility, due to a physical, mental or emotional condition lasting six months or more. "People are living longer, but many are also living sicker," said study co-author Amani Nuru-Jeter, assistant professor of community health and human development at UC Berkeley's School of Public Health. "This study is providing an early warning sign that the decline in disability rates we've been hearing about might be ending." The authors pointed to the potential to stem the increase in disability rates through health care reform. "About two-thirds of Medicaid spending and over a third of Medicare spending are associated with disability, so any increase in costs due to increased disability is a federal liability," added Nuru-Jeter. "If we do nothing, those costs will grow as more middle-aged adults develop diseases that lead to disability because they lack preventive services or are uninsured. If we cover all children and adults, we are likely to slow or even reverse this trend." Most of the people in this study were 65 and over and already covered by Medicare or Medicaid. The researchers said the rise in disability among those living in the community could be partially attributed to the decrease in elderly adults living in nursing homes. "People are less likely to go to a nursing home compared to 20 years ago," said Fuller-Thomson. "Today, there are more options, such that only those with the most serious physical health problems, and lack of alternatives, go to long-term care facilities."