Age-specific trends in limitations of daily activities in American adults aged 50-84 by race and ethnicity, 2000-2018.

Abstract

During the first decade of the 2000s, disability levels began to stagnate or increase among American adults, a sharp departure from broad declines observed in earlier decades. It is unclear whether these adverse trends have continued after 2010, and whether there are variations by age group, sex, race/ethnicity, and nativity status. We used data from the 2000-2018 National Health Interview Survey to investigate trends in limitations of activities of daily living (ADL) and instrumental activities of daily living (IADL) by age group, race/ethnicity, and nativity among the 50 + population. We evaluated trends within the 2000-2009 and 2010-2018 periods. We find that adverse trends in disability documented in 2000-2009 continued into the 2010-2018 period, although the groups experiencing the largest increases shifted between decades. Middle-aged (50-64 years) adults displayed the most adverse trends compared to those ages 65-74 and 75-84, with some subgroups experiencing over 100% relative increases in ADL limitations. Disparities in disability by race/ethnicity widened considerably, with an alarming increase in disability among US-born Hispanics, particularly women at middle age, in the 2010-2018 period, while in the previous decade, Non-Hispanic Blacks and Non-Hispanic Whites presented the largest increases in IADL and ADL prevalence. Foreign-born Hispanics, who maintained the lowest disability levels through 2010, also experienced significant increases in the second decade. These trends provide an evidence base for understanding the direction of longer-term disability trajectories in the U.S. population and highlight the need for targeted prevention efforts among middle-aged adults and vulnerable demographic groups.