Vicki A. Freedman, Ph.D.
University of Michigan
Brenda C. Spillman, Ph.D.
Office of Disability, Aging and Long-Term Care Policy
Office of the Assistant Secretary for Planning and Evaluation
U.S. Department of Health and Human Services
The opinions and views expressed in this report are those of the authors. They do not necessarily reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. The authors thank Patti Andreski for her programming assistance.
The economic cost of dependency at older ages is large and projected to grow rapidly as the number of older adults increases in the coming decades, and reduced well-being for individuals facing loss of functioning and their families, who provide the bulk of uncompensated care, also is an important societal concern. The purpose of this report is to describe disability and care needs of the older population using baseline (2011) measures from the National Health and Aging Trends Study, a new study designed to support understanding of both trends and trajectories in health and disability in later life. To provide a context for framing policy discussions of disability and care needs of older adults, Two overarching topics were investigated: (1) the extent of activity limitations and use of assistance by older adults; and (2) care resources available to and used by older adults and the extent of unmet need in the population with care needs.
Studies of the prevalence of Alzheimer’s disease and other dementia in the U.S. estimate that 14% of those over age 70 are affected, and that prevalence increases with age, exceeding one-quarter of persons over age 80. The implications of population aging for increases in older persons with dementia and the impact on families, which will be the mainstays in caregiving, have been recognized worldwide in a 2012 World Health Organization report on Dementia as a Public Health Priority, and in the U.S. by the National Alzheimer’s Project Act of 2012. This report uses the National Health and Aging Trends Study (NHATS), to describe late life disability and care needs of older adults with dementia. Using a dementia classification developed previously, we examine patterns for older adults with probable, possible and no dementia in the extent of activity limitations, receipt of assistance, and caregiving resources.