Temporal trends in self-reported functional limitations and physical disability among the community-dwelling elderly population: The Framingham Heart Study

Objectives. We sought to determine change in the prevalence of functional limitations and physical disability among the community-dwelling elderly population across 3 decades. Methods. We studied original participants of the Framingham Heart Study, aged 79 to 88 years, at examination 15 (1977-1979; 177 women, 103 men), examination 20 (11988-11990,159 women, 98 men) and examination 25 (1997-1999; 174 women, 119 men). Self-reported functional limitation was defined using the Nagi scale, and physical disability was defined using the Rosow-Breslau and Katz scales. Results. Functional limitations declined across examinations from 74.6% to 60.5% to 37.9% (P <.601) among women and from 54.2% to 37.8% to 27.8% (P <.001) among men. Physical disability declined from 74.5% to 48.5% to 34.6% (P <.001) among women and 42.3% to 33.3% to 22.8% (P=.009) among men. Among women, improvements in functional limitations (P=.05) were greater from examination 20 to 25, whereas for physical disability (P=.02), improvements were greater from examination 15 to 20. Improvements in function were constant across the 3 examinations in men. Conclusions. Among community-dwelling elders, the prevalence of functional limitations and physical disability declined significantly in both women and men from the 1970s to the 1990s. This may in part be due to improvements in technological devices used to maintain independence. Further work is needed to identify the underlining causes of the decline so preventative measures can be established that promote independence for the elderly population.