Activities of daily living (ADL) and instrumental activities of daily living (IADL) disability in Swedish 85-year-olds born three decades apart—findings from the H70 study

Abstract

Abstract Objective Older adults make up the fastest growing segment of the population, and disability rates increase with age. There is much debate whether later born cohorts of 85-year-olds will face the same disability rates as earlier born cohorts. This study aimed to examine ADL and IADL disability in three birth cohorts of Swedish 85-year-olds born three decades apart, examined in 1986–87, 2008–10 and 2015-16, as well as potential factors associated with ADL and IADL disability in these birth-cohorts. Methods Systematically selected population-based birth cohorts of 85-year-olds (n = 1,551) from the Gothenburg H70 Birth Cohort studies, Sweden, born in 1901–02 (n = 494), 1923–24 (n = 571) and 1930 (n = 486) and examined with identical methods. Disability was defined as a need for assistance in any ADL/IADL activities. Results ADL/IADL disability decreased between cohorts in both men and women (from 76.7% in 1986–87, to 58.4% in 2008–10, and 48.4% in 2015–16, P-value trend <.001). Factors associated with ADL/IADL disability varied between cohorts, although dementia and depression increased the odds of disability in all three birth cohorts. Conclusion Later born cohorts of 85-year-olds face less ADL/IADL disability compared to earlier born cohorts. As disability poses a significant financial burden on healthcare services, our findings might contribute to a more positive view on global ageing and the demographic challenges ahead. However, it might also be that in later born cohorts, ADL/IADL disability affects people at later ages, but due to increased longevity, the total number of years in late-life with a functional disability will remain the same.