The journal of nutrition, health & aging

, Volume 23, Issue 2, pp 172–174 | Cite as

The Burden of Functional Disabilities for Middle-Aged and Older Adults in the United States

  • Ryan McGrathEmail author
  • S. Al Snih
  • K. Markides
  • K. Hackney
  • R. Bailey
  • M. Peterson



Understanding the role of functional capacity on longevity is important as the population in the United States ages. The purpose of this study was to determine the burden of instrumental activities of daily living (IADL) and activities of daily living (ADL) disabilities for a nationally-representative sample of middle-aged and older adults in the United States.




Core interviews were often performed in person or over the telephone.


A sub-sample of 31,055 participants aged at least 50 years from the 1998–2014 waves of the Health and Retirement Study who reported having a functional disability were included.


Ability to perform IADLs and ADLs were self-reported at each wave. The National Death Index was used to ascertain date of death. The number of years of life that were lost (YLLs) and years lived with a disability (YLDs) were summed for the calculation of disability-adjusted life years (DALYs). Sampling weights were used in the analyses to make the DALYs nationally-representative. The results for YLLs, YLDs, and DALYs are reported in thousands.


Of the participants included, 14,990 had an IADL disability and 13,136 had an ADL disability. Men and women with an IADL disability had 236,037 and 233,772 DALYs, respectively; whereas, there were 178,594 DALYs for males and 253,630 DALYs for females with an ADL disability. Collectively, there were 469,809 years of healthy life lost from IADL impairments, and 432,224 years of healthy life lost from ADL limitations.


These findings should be used to inform healthcare providers and guide interventions aiming to preserve the functional capacity of aging adults. Prioritizing health-related resources for mitigating the burden of functional disabilities may help aging adults increase their quality of life and life expectancy over time.

Key words

Geriatrics morbidity mortality rehabilitation 

Supplementary material

12603_2018_1133_MOESM1_ESM.docx (21 kb)
Appendix 1. Results of the Disability-Adjusted Life Years for Functional Disabilities by Sex.


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Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  • Ryan McGrath
    • 1
    • 6
    Email author
  • S. Al Snih
    • 2
  • K. Markides
    • 3
  • K. Hackney
    • 1
  • R. Bailey
    • 4
  • M. Peterson
    • 5
  1. 1.Department of Health, Nutrition, and Exercise SciencesNorth Dakota State UniversityFargoUSA
  2. 2.Division of Rehabilitation SciencesUniversity of Texas Medical BranchGalvestonUSA
  3. 3.Department of Preventive Medicine and Community HealthUniversity of Texas Medical BranchGalvestonUSA
  4. 4.Brown School of Social WorkWashington University in St. LouisSt. LouisUSA
  5. 5.Department of Physical Medicine and RehabilitationUniversity of MichiganAnn ArborUSA
  6. 6.North Dakota State University, NDSU Dept. 2620FargoUSA

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