Wharton Pension Research Council Working Papers

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Working Paper

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This paper examines how inability to perform activities of daily living relates to the risk of nursing home admission over older adults’ life courses. Using longitudinal data on persons over age 50 from the Health and Retirement Study, we show that aging one year boosts the probability of having two or more disabilities by 9 to 12 percent in a multivariate logistic model. Moreover, at least three-fifths of all 65-year-old men and three-quarters of women will experience disability levels during their remaining lifetimes severe enough to trigger nursing home admission. Our analysis also suggests that certain types of disability are more important than others in predicting nursing home admittance and use, which has implications for the design and benefit triggers for long-term care insurance programs.

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Copyright/Permission Statement

All findings, interpretations, and conclusions of this paper represent the views of the authors and not those of the Wharton School or the Boettner Center for Pensions and Retirement Research. © 2012 Boettner Center of the Wharton School of the University of Pennsylvania. All rights reserved.


The authors gratefully acknowledge support from the Sim Kee Boon Institute for Financial Economics at Singapore Management University, the Centre of Excellence in Population Ageing Research at the Australian School of Business of the University of New South Wales, and the Pension Research Council and Boettner Center at the Wharton School of the University of Pennsylvania. Jun Feng and Yong Yu provided capable research assistance.

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Date Posted: 28 June 2019