Foundations of ADL Trajectories of Older Americans

Linda G. Martin, RAND Corporation
Jinkook Lee, RAND Corporation

The disablement process may be viewed as a progression from disease to impairment to functional limitation and finally to activity limitation (frequently called “disability”). We use data from seven waves of the Health and Retirement Study, 1998 to 2010, to investigate for individuals ages 65 to 84 how different types of baseline functional limitation (physical, cognitive, sensory), as well as baseline self-reported diseases and pain, are related to the dynamics of limitations in activities of daily living (ADLs). Our modeling approach jointly estimates multi-period trajectories of ADL limitation and mortality and yields estimates of the number of, shapes of, and risk factors associated with the most common trajectories.