What are the trends in growing older in America?

Challenge

How can we improve care for older adults with Alzheimer’s Disease? How can we support family caregivers in care delivery? The National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC) provide important data about the daily lives of older adults and their unpaid caregivers in the U.S. Both are funded by the National Institute on Aging (NIA). NHATS is part of a cooperative agreement among the Johns Hopkins University Bloomberg School of Public Health (JHSPH) and the University of Michigan’s Institute for Social Research (UMISR).

The goals of NHATS are to understand late-life health and functioning, how these differ for various groups of older adults, and the consequences of late-life disability for individuals, families, and society. Thousands of participants are interviewed each year about their daily activities. By interviewing participants where they live, NHATS is able to include older adults with disabilities or who are in nursing homes or other care facilities and who may be excluded from research conducted in clinical settings. NHATS strives to include and accurately represent aging American populations and reduce bias in research for minorities.

People who help NHATS participants may be interviewed as part of NSOC. NSOC interviews individuals who have helped a relative or friend who is participating in NHATS. Since 2011, more than 7,000 people have participated in NSOC.

Solution

NHATS collects data each year from about 10,000 Medicare beneficiaries ages 65 and older in the setting where they live. Respondents are sampled and recruited from diverse ethnic and racial groups and represent all age groups from age 65 to centenarians. NHATS has a supplemental sample of older Hispanic Americans.

Interviewers use laptops for computer-assisted personal interviewing (CAPI) and tablets to administer vision, hearing, and cognitive tasks; smartphones for observational tasks and paradata collection; and special watches to collect activity data. Participants are asked about their health, their home, how they do their everyday activities, how they get around at home and in the community, their family, and the people in their lives who may help with everyday activities. Participants also perform simple everyday activities that include standing, getting up from a chair, walking, and that measure memory, vision, and hearing.

Each year, NSOC interviews over 2,000 family and unpaid caregivers of NHATS participants whose limitations interfered with daily activities. The interviews are conducted by phone and online. The research enriches our understanding of the activities for which help is provided, its duration and intensity, support services used, and how caregiving impacts their health, well-being, work, childcare, and other activities.

Results

NHATS is providing inclusive and representative data of late-life functioning among older adults. Researchers are using these data to explore ways to reduce disabilities, maximize health and independent functioning, and enhance quality of life for aging Americans today and in the future. NSOC is increasing awareness about the caregiver experience and how it can be improved. Together, NHATS and NSOC are delivering critical insights about how daily life changes as we age and how aging Americans can lead fuller, healthier lives.