Being on Your Own as You Age

Disability may make it harder for older women to stay independent than for older men

(RxWiki News) Self-care helps shape the quality of life for most people. That is no less true for many aging individuals, who also desire to dress and feed themselves, get around on their own and so forth.

A new study suggests that, during the last two years of life, women may have more trouble than men keeping their independence.

"More than one-third of all older adults can expect to need assistance with...disability one year prior to death, and more than one-quarter [will need help] two years prior to death," the researchers wrote.

"Have a plan in case of disability."

This study's lead researcher was Alexander K. Smith, MD, MS, MPH, who investigates aging and medical care for pain at the University of California San Francisco School of Medicine. 

Dr. Smith and his fellow researchers looked at the level of independence experienced by 8,232 people in the last two years before they died. The average age at the time of death was 79, and women accounted for 52 percent of the group.

For this investigation, anyone needing help to dress, eat, bathe, use the toilet or move from, for example, the bed to a chair were defined as disabled. To be labeled as disabled, study participants needed help in one or more of those categories.

These researchers found, overall, that 28 percent of the 8,232 studied individuals were disabled during the last two years of life. During the last month of life, 56 percent were disabled.

Of the studied women, 32 percent were disabled during the last two years of life. That compares to 21 percent of men being disabled during the last two years of their lives.

The researchers also found that 14 percent of 50- to 69-year-olds were disabled during the last two years of life. Among those aged 70 to 79, 21 percent were found to be disabled during the same period. Among those aged 80 to 89, 32 percent were disabled during that period. Half of those aged 90 and older were disabled during those final years.

This research was conducted in response to the substantial growth of the population of older Americans. The population of adults in the United States who are older than 85 is expected to roughly triple by 2050, eventually standing at 19 million people, the researchers wrote.

Many people in their 80s and 90s are not disabled, the researchers said in a press release. Their study, however, aimed to spotlight what many aging people might expect in the future. 

"Nearly all older adults will have difficulty walking or climbing stairs two years before death. Half of all older adults who live to their tenth decade will be disabled in...two years prior to death, and more than two-thirds [will need help] six months prior to death, and thus be dependent on the help of family or paid caregivers...," they wrote.

The researchers continued, "Our data do raise the question of whether it makes sense to sell the public a view of aging that purports that it is reasonable to expect to both live a long life and remain free of disability throughout life. Our findings add to the evidence that those who live to advanced ages will spend greater periods of time in states of disability than those who die at younger ages."

The study's participants were at least 50 years old. They were interviewed once during that last 24 months of living. They died between 1995 and 2010, when they also were enrolled in the Health and Retirement Study.  

This study was published July 8 in the JAMA Internal Medicine. 

The researchers did not disclose any investments or other activities that would influence study design or outcomes.

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Review Date: 
July 7, 2013