Getting Better and Getting Worse

Abstract

This article examines change over 2 years in ability to perform 21 specific functions among Americans 70 years of age and over. Health change in old age is two-directional. Ability to perform specific functions improves for some and deteriorates for others. In addition, many individuals experience both types of functioning change at the same time—improvement in the ability to perform some functions and deterioration in ability to perform others. The covariates of functional improvement differ from those of functional loss. The return to functioning is most likely to occur when the overall functional status of the individual is higher, when the loss has been recent, and when the impairment is not severe. Decline in ability to perform specific functions is more likely when general health and functioning levels are lower and when a person has had a stroke, has arthritis, or has visual or auditory impairment. Age, race, and sex are related to the likelihood that functioning will deteriorate, but they have little effect on the likelihood of improvement.