Smiling senior man
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Older adults saw a “substantial” decline in activities of daily living limitations compared with a decade earlier, according to the results of a new study.

The findings show a wide range of benefits for older adults, their families and caregivers, and the US healthcare system, according to the authors.

The study, published in the International Journal of Environmental Research and Public Health, is based on data from the American Community Survey of 5.4 million community- and institution-dwelling older adults from 2008 to 2017.

According to the findings, 12.1% of older Americans in 2008 reported ADL limitations, compared with 9.6% in 2017. Similarly, the percentage of functional limitations (such as serious difficulty walking or climbing stairs) among those 65 and older declined from 27.3% in 2008 to 23.5% in 2017. 

Improvements among women were greater than they were for men. Women’s odds of experiencing ADL limitations decreased by 20% compared with 13% for men. The odds of women experiencing functional limitations decreased 16% compared with 8% for men.

The study also found a more modest decline in disability among baby boomers — who have higher rates of obesity — compared with members of older generations.

Higher education, health literacy and health promoting behaviors contributed to drops in limitations experienced by older adults. Other potential contributing factors included decreases in smoking and levels of air pollutants, and the phase-out of leaded gasoline in the 1970s.

“Higher educational attainment increases healthy literacy and health promoting behaviors,” co-author Katherine Ahlin said in a statement. “One’s education levels also impact job type, which affects cardiovascular risk factors. And the lower one’s cardiovascular risk factors, the lower one’s levels of disability later in life.”

Data reveal senior living specifics

The findings align with those of another recent study specific to senior living, from the American Seniors Housing Association. It found changes to the health and financial status of independent living residents.

According to ASHA’s Independent Living Then and Now report, self-rated health status declined among independent living residents between 2012 and 2019, but there also was a notable drop in falls, hospitalizations and the proportion of residents requiring ADL assistance.

A December brief from the Center for Disease Control and Prevention’s National Center for Health Statistics found that when it comes to assisted living residents, overall, the most commonly need assistance with bathing (64%), followed by walking (50%), dressing (49%), toileting (43%), transferring (34%) and eating (22%). But rates varied when examined by community size, with the need for ADL assistance generally decreasing in larger communities 

The rate of ADL assistance needed among residents was highest in assisted living communities with four to 25 beds.

The CDC brief noted that smaller communities are home to a higher percentage of Medicaid beneficiaries living with Alzheimer’s disease or other dementias compared with larger communities.