Cohort Differences and Chronic Disease Profiles of Differential Disability Trajectories

Abstract

Research shows declining disability rates, but little is known about whether cohort differences are due to delayed onset, increased recovery, or reduced severity of impairment. Furthermore, disease is considered the proximate cause of disability yet chronic conditions rates are increasing, making it unclear whether the conditions predicting specific disability trajectories are changing. We use a latent class analysis of disability trajectories and corresponding mortality with three birth cohorts of the National Long-Term Care Survey to determine how long-term experiences of disablement differ by cohort and chronic conditions. More recent cohorts were more likely to experience a decade free of disablement compared with all other disability trajectories. Sensory problems and hypertension correspond to trajectories of non-disablement, whereas hip fracture, stroke, arthritis, and diabetes predict more disabled experiences. Later life disability is measured nonparametrically to distinguish patterns among long-term trajectories. Findings suggest that more recent cohorts are more likely to forego or delay disability over a decade rather than experience prolonged periods of mild to severe disablement. Serious health events such as stroke, along with diabetes, characterize trajectories of high impairment, warranting future research.