Clinical Pathways to Disability
This paper examines the pathways by which individuals transition from healthy to disabled. Because of the high prevalence and costs associated with disability, understanding these pathways is critical to developing interventions to prevent or minimize disability. We compare two estimates of disabling conditions: those observed in medical claims and conditions indicated by the disabled individual. A small number of conditions explain about half of incident disability: arthritis, infectious disease, dementia, heart failure, diabetes, and stroke. These conditions show up in medical claims and self reports. A large number of elderly also attribute disability to old age and various symptoms. Because so many of the most disabling conditions do not have clear medical treatments, the outlook for major reductions in disability might be limited.
This work was funded by the National Institute of Aging (P30 AG12810 and R01AG019805) and
the Mary Woodard Lasker Charitable Trust and Michael E. DeBakey Foundation. The views expressed
herein are those of the author(s) and do not necessarily reflect the views of the National Bureau of
Clinical Pathways to Disability, Mary Beth Landrum, Kate A. Stewart, David M. Cutler. in Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly, Cutler and Wise. 2008