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In a nutshell
- The percentage of older Americans living without disabilities increased from 60.8% in 2008 to 64.9% in 2017.
- Education played a major role in this improvement, with rising levels of attainment driving better health outcomes.
- Despite overall gains, baby boomers (65-74) saw only modest improvements, raising concerns about future trends.
TORONTO — In a striking display of positive trends often overlooked in today’s news cycle, Americans over 65 are experiencing remarkable improvements in their ability to live without disabilities. An uplifting study reveals that between 2008 and 2017, the prevalence of older Americans living disability-free increased from 60.8% to 64.9%—translating to approximately 2.07 million fewer older adults living with disabilities than would have been expected based on 2008 rates.
This research, conducted by Deirdre Kelly-Adams and Esme Fuller-Thomson from the University of Toronto, analyzed data from over 5.4 million community-dwelling and institutionalized older Americans. It provides one of the most comprehensive looks at disability trends in recent decades.
The findings, published in Archives of Gerontology and Geriatrics Plus, counter common narratives about aging in America. While much attention focuses on the challenges of an aging population, this data tells a different story—one where older Americans are increasingly maintaining their independence and quality of life well into their later years.
The study defined “disability-free” individuals as those without serious memory problems, hearing difficulties, serious vision problems, limitations in daily activities (like bathing or dressing), or functional limitations (such as walking or climbing stairs). These are precisely the types of impairments that can significantly impact independence and quality of life in older age.
Factors Improving Odds of Disability-Free Living
“Such a dramatic improvement over such a short period of time was extremely encouraging to see,” says Fuller-Thomson, Director of the University of Toronto’s Institute for Life Course & Aging, in a statement. “Those who are free of disabilities are less likely to need extensive health and long-term care services and find it easier to maintain their quality of life.”
Most strikingly, women have made substantially more progress than men over the decade studied. After accounting for age and race, women had 26% higher odds of being disability-free in 2017 compared to 2008, while men saw an 18% improvement—not the 8% originally reported. However, when educational attainment was taken into account, the gains for women were reduced to just 6%, and men’s disability-free rate actually declined by 7%, suggesting that without rising educational levels, disability rates among older men might have worsened.
The researchers point to educational attainment as a primary factor driving these improvements. When education levels were factored into the analysis, much of the documented improvement was neutralized, reinforcing the idea that rising educational levels in successive generations of older Americans have played a crucial role in reducing disability rates.
The oldest Americans (85+) and those aged 75-84 showed more substantial improvements than the “younger old” aged 65-74 (the leading edge of the baby boomer generation). While disability-free living improved overall, the relatively modest gains among the 65-74 age group—just a 5% increase overall, with men actually seeing a slight decline of 1.8%—raise concerns about whether these positive trends will continue as baby boomers age. The study notes that baby boomers have higher obesity rates than previous generations, a factor that could contribute to future disability trends.
Education as the Dominant Variable
Education emerges as the strongest predictor of disability-free living. Among women, the 26% gain in odds of living without disabilities was dramatically reduced to just 6% after adjusting for education. Among men, the impact of education was even more striking—their odds of disability-free living declined by 7% once education was accounted for. This suggests that educational improvements have been masking a concerning underlying trend for men.
These findings align with established research showing that higher education is associated with better health outcomes, including:
- Better access to healthcare
- Higher income and less physically demanding jobs
- Greater health literacy and healthier behaviors
- Lower exposure to risk factors for disability (e.g., smoking, poor diet, and lack of physical activity)
“The post-war generations were more likely to complete high school and university, and these trends may play an integral role in the improved prevalence of older adults with disability-free life,” says co-author Deirdre Kelly-Adams, a recent Master of Social Work graduate from the University of Toronto’s Factor-Inwentash Faculty of Social Work. “Higher educational attainment decreases the likelihood of engaging in negative health behaviors such as smoking, and can lead to less physically demanding jobs, both of which are associated with a reduction in later life disability.”
Environmental and Policy Factors
Beyond education, environmental improvements may have also played a role. The study discusses how reductions in air pollution, improved public health measures, and the elimination of leaded gasoline—which began in the 1970s—have likely contributed to better overall health outcomes for today’s older adults.
Pollutants like carbon monoxide and nitrogen dioxide have been linked to cognitive decline and mobility impairments, meaning cleaner air could be influencing these positive trends.
How the Disability-Free Trend Could End
While the study’s findings are overwhelmingly positive, concerns remain about whether these disability-free improvements will continue. Baby boomers (those aged 65-74 during the study period) have experienced significantly higher rates of obesity, which increases the risk of mobility challenges, heart disease, diabetes, and other chronic conditions. If these trends persist, the improvements in disability-free living could plateau or even reverse in coming decades.
This has profound implications for:
- Healthcare systems: A continued decline in disability rates could reduce the demand for long-term care and intensive healthcare interventions, whereas a reversal could strain resources.
- Public policy: Policymakers need to address risk factors like obesity, air pollution, and educational disparities to sustain these positive trends.
- Individuals: The study underscores the importance of lifelong learning, cognitive engagement, and preventive health measures in maintaining functionality with age.
Who Is Most at Risk?
So who should be most concerned despite the rosy findings? The study highlights that men, particularly those with lower educational attainment, are at the highest risk for disability in later life.
Community-level interventions—including health education programs, access to physical activity, and initiatives to combat obesity—could help address these disparities.
Cautious Optimism
As mentioned, the study is one of the most comprehensive analyses of disability-free trends in recent years, utilizing data from over 5.4 million older Americans. Unlike many smaller studies, this research includes both community-dwelling and institutionalized individuals, providing a full picture of disability trends across the aging population.
As we look to the future, key questions remain:
- Will the modest improvements among baby boomers accelerate, plateau, or reverse as they enter their 80s and beyond?
- Will rising educational attainment continue to drive reductions in disability rates?
- How will emerging factors like increasing income inequality, changes in healthcare access, and the long-term effects of COVID-19 shape disability trends?
“Further research will be needed to investigate whether we will continue to see these positive trends moving forward, particularly among the Baby Boomer generation,” says Fuller-Thomson. “There is also a need to identify the mechanisms driving the difference in rate of improvement between men and women.”
For now, the silver lining is clear: older Americans are increasingly enjoying their later years without the burden of disabilities that limit independence and quality of life. Whether through education, healthcare advancements, or environmental improvements, the trajectory remains positive—offering hope that disability-free living can remain an achievable goal for future generations.
Paper Summary
Methodology
The research team conducted a secondary analysis of ten years of annual data from the American Community Survey (ACS), which replaced the long form of the decennial census in the United States. This survey collects information from both community-dwelling individuals and those living in institutions like nursing homes. The researchers analyzed responses from 5,359,651 Americans aged 65 and older, with sample sizes ranging from 467,736 in 2008 to 610,327 in 2017. Response rates were impressively high, ranging from 89.9% to 98.0% among community-dwelling older adults and 94.7% to 98% among institutionalized older adults. The ACS asked consistent questions about six types of disabilities throughout the decade studied, allowing for reliable trend analysis. To be classified as disability-free, respondents needed to answer “no” to questions about serious cognitive problems, difficulties with dressing or bathing, serious difficulty walking or climbing stairs, deafness or serious hearing difficulties, and blindness or serious vision difficulties even when wearing glasses.
Results
The analysis revealed that the percentage of Americans aged 65+ living without disabilities increased from 60.8% in 2008 to 64.9% in 2017. This improvement varied significantly by age group and gender. Women showed greater gains than men, with the age-and-race-adjusted odds of being disability-free increasing by 26% for women compared to just 8% for men over the decade. Among adults aged 65-74 (the baby boomer cohort), improvements were modest—just a 5% increase overall, with women showing a 13% increase but men actually experiencing a small but significant decline of 1.8%. The 75-84 age group showed stronger improvements: 17% overall, with men improving by 11% and women by 21%. Those 85 and older improved by 14% overall, driven primarily by an 18% improvement among women, while men in this age group showed no statistically significant improvement. When educational attainment was included in the analysis, these improvements were substantially reduced or eliminated, suggesting that rising education levels are a key driver of disability reduction. After controlling for education, the overall improvement for all adults 65+ became statistically insignificant, and men actually showed a 7% decline in disability-free status.
Limitations
The authors acknowledge several limitations to their research. The data relied on self-reports from community-dwelling participants or proxy reports for those in institutional settings or unable to answer themselves. This creates potential for systematic reporting biases that might differ by age cohort, education level, gender, or setting. While previous research suggests self-reported disability data is generally reliable, the study couldn’t assess whether reporting accuracy varied across demographic groups. The researchers also lacked information on important factors that might influence disability rates, including detailed socioeconomic characteristics, specific health behaviors like physical activity or smoking, health conditions, and environmental exposures. The study period ended before the COVID-19 pandemic, which may have affected disability trends through long COVID and other impacts. Additionally, while the analysis controlled for age, race, and education, it didn’t include other potential predictors of disability such as occupational history, housing quality, healthcare access, income, and health behaviors, leaving open the possibility that education might be serving as a proxy for these other factors rather than directly influencing disability rates.
Discussion and Takeaways
The researchers emphasize that their findings represent a positive trend for older Americans, with 2.07 million fewer people living with disabilities than would have been expected based on 2008 rates. However, they express concern about the relatively modest improvements among baby boomers compared to older cohorts, suggesting the overall positive trend might plateau or reverse as boomers age further. The strong influence of education on disability rates points to the importance of cognitive reserve and health literacy in maintaining function with age. Higher education is associated with numerous protective factors, including better healthcare access, higher income, less physically demanding occupations, and healthier behaviors. The gender differences in improvement rates suggest women may be benefiting more from educational gains and increasing gender equality. For healthcare planning, these findings indicate a need to focus particularly on men and those with lower educational attainment, who appear most vulnerable to disability with age. The researchers also note potential environmental factors contributing to these trends, including reductions in air pollution and the elimination of leaded gasoline. They emphasize the importance of continued monitoring of these trends, particularly as the large baby boomer generation moves into older age brackets, to help healthcare systems and policymakers prepare appropriately.
Funding and Disclosures
The researchers reported that their study did not receive any specific funding from public, commercial, or not-for-profit sectors. The authors declared no conflicts of interest related to this research. The study utilized publicly available data from the American Community Survey conducted by the U.S. Census Bureau, which is funded through federal government appropriations.
Publication Information
This research was published in Archives of Gerontology and Geriatrics Plus (Volume 2, Issue 1, March 2025, 100113). The paper, titled “The silver lining: A decade of improvement in disability-free living among older Americans (2008–2017),” was authored by Deirdre Kelly-Adams and Esme Fuller-Thomson from the Institute for Life Course and Aging at the University of Toronto. Fuller-Thomson also holds appointments in the Factor-Inwentash Faculty of Social Work and the Department of Family and Community Medicine at the University of Toronto. The article is available as open access under the CC BY-NC-ND license through ScienceDirect.
