Disability Transitions for Older Persons with Arthritis

Abstract

This article reports changes over 2 years in physical, activities of daily living (ADL), and instrumental activities of daily living (IADL) disabilities for older U.S. adults with arthritis, compared to those without arthritis. The data source is the 1986 Longitudinal Study on Aging, a follow-up survey of community-dwelling persons ages 70 and over when first interviewed in 1984 (N = 4,717). Disability is defined as difficulty doing an activity on one's own and without special equipment. Transitions from tO status (1984: No Difficulty, Yes Difficulty) to ti status (1986: No Difficulty-Community Dwelling, Yes Difficulty-Community Dwelling, Institutional Residence, Dead) are studied. (a) Among nondisabled persons at to, people with arthritis are more likely to incur all types of disability over a 2-year period. (b) Among disabled persons at tO, those with arthritis regain ADL, IADL, and walking abilities more readily than do their nonarthritis peers, but they are less likely to regain physical functions requiring endurance, strength, and dexterity. (c) Regardless of initial disability status, nonarthritis people are more likely to be institutionalized or die in 2 years than are arthritis persons. (These results are clear but vary in statistical strength: Most comparisons for [a] are significant at p ≤ .01; one third are significant at p≤ .05 for [b]; most comparisons for institutional outcome are nonsignificant due to small cell sizes; one third for dead outcome are significant at p ≤ .01.) The results reflect the medical nature of arthritis (musculoskeletal locale, moderate impact, nonfatal) and also people's successful accommodations to it. In sum, disability is an especially dynamic experience for persons with arthritis. Clinical and public health efforts to prevent disability onset and to aid restoration of function for this common disease can have high payoff, benefiting many persons for relatively low cost.