Recent Changes in the Health Status of the Older U.S. Population: Findings from the 1984 and 1994 Supplement on Aging

OBJECTIVES: To examine the changes in the use of health care services, physical functioning, disability, and other aspects of health status in the older U.S. population between 1984 and 1994. DESIGN AND SETTING: The 1984 and 1994 National Health Interview Survey Supplements on Aging, which were national probability samples of the civilian, noninstitutionalized population age 70 and older. PARTICIPANTS: A total of 7,541 and 9,447 persons, representing the 17.3 million and 21.8 million U.S. population age 70 and older in 1984 and 1994, respectively. MEASUREMENTS: Annual bed-limitation days, doctor visits, episodes and days of hospital stays, limitation in 10 measures of physical performance, disability in seven activities of daily living (ADLs) and six instrumental activities of daily living (IADLs), and participation in social activities and exercise. RESULTS: The annual bed-limitation days and hospital stays declined significantly in both men and women between 1984 and 1994. There was a large decrease in the prevalence of limitation in physical performance and a smaller decrease in disability of IADLs. The changes were greater in women than in men. The prevalence of disability in ADLs was not changed in women in general and increased somewhat in men. Significant increases in the proportion of persons participating in certain social activities and regular exercise were found in both men and women. Jointly considering the indicators, including annual bed days and hospital stays, physical performance, ADLs, and IADLs, 4.2% more men and 3.1% more women were physically robust in 1994 than in 1984. Approximately 420,000 more older people would have lived in a severely restricted and disabled state in 1994 if the rate of limitation had not declined. CONCLUSION: This study provides evidence of an overall improvement in the health status of older Americans but inconsistency in the trends existed for different disability measures and for population subgroups.