Conceptualizing and Measuring Disability in the National Health and Aging Trends Study

Disability measures in NSAH will support analyses in several broadly defined areas: 1) Understanding the relative contributions of shifts in physiologic, socioeconomic, environmental, behavioral, and medical factors to trends in disability prevalence, onset, and recovery; 2) Investigations into which combinations of these factors lead to different disability pathways at the individual level and how and why pathways differ for less advantaged groups; and 3) Comprehensive modeling of outcomes of the disablement process, including living and care arrangements, medical and long-term care expenditures, and other aspects of economic well-being and quality of life. This presentation will address conceptualization and measurement of disability in NSAH. Building on concepts outlined in the Institute of Medicine's disablement framework and the World Health Organizations International Classification of Functioning, NSAH plans to collect information to disentangle the notion of disability into several major components: an individual's underlying capacity to carry out basic physical, cognitive, and sensory tasks; the ability to carry out basic tasks and essential self-care and household maintenance activities independently, and the extent of engagement in household maintenance and valued (elective) activities. In addition, NSAH will include new measures of the physical, social, and technological environment and accommodations that individuals make in response to such as use of assistive technology, environmental modifications, assistance from another person, and other changes in behavior (doing tasks less often or avoiding altogether tasks and environments).