Estimates of change in chronic disability and institutional incidence and prevalence rates in the U.S. elderly population from the 1982, 1984, and 1989 National Long Term Care Survey.

The U.S. elderly (65+) and oldest-old (85+) populations are growing rapidly which, combined with their high per capita acute and long-term care needs, will increase total U.S. health care needs. Also important in determining needs is how health and function change as mortality declines in the elderly population. Recent increases in adult life expectancy have been due to declines in stroke and heart disease mortality. There is controversy, however, about how those declines relate to the health and function of survivors. We examined changes in the prevalence and incidence of chronic disability using the 1982, 1984, and 1989 National Long Term Care Surveys. The total prevalence of U.S. chronically disabled community-dwelling and institutionalized elderly populations declined from 1984 to 1989, overall, for each of three age strata and after mortality adjustment. These changes varied over level of disability. Factors contributing to these changes, including measurement, are reviewed.