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Prevalence of Self-Reported Functional Limitations among U.S. Adults Aged ≥ 65 Years, 2013–2018

Prevalence of Self-Reported Functional Limitations among U.S. Adults Aged ≥ 65 Years, 2013–2018

A higher prevalence of adults aged ≥ 65 years with chronic kidney disease (CKD) reported functional limitations with hearing, seeing, concentrating, walking, dressing, and running errands than those without CKD. The most frequently reported limitation was walking.

Data Source: NHANES

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Limited to adults aged 65 years and older. Data are not adjusted.

NHANES is a nationally representative, cross-sectional survey that is currently conducted every two years (since 1999) by CDC's National Center for Health Statistics among noninstitutionalized US civilian residents. The survey consists of a standardized in-home interview and a physical examination with blood and urine collected at a mobile examination center. Data were examined by combining two NHANES cycles to represent four-year periods from 2001 to 2016 and the 2017–March 2020 pre-pandemic cycle.

Note: Not all NHANES variables are collected for all years; therefore, some NHANES indicators may not utilize the full 20-year span.

FieldData
Description of Measure

Prevalence of functional limitations among U.S. adults aged ≥ 65 years.

Data Set

National Health and Nutrition Examination Survey (NHANES).

Population

Noninstitutionalized U.S. adults aged ≥ 65 years.

Years Included

2013–2018.

Numerator

Adults aged ≥ 65 years who reported having each functional limitation, including hearing, seeing, concentrating, walking, dressing, or bathing, or running errands alone.

Denominator

Adults aged ≥ 65 years who completed the disability survey and had measurements of serum creatinine and urine albumin.

Definition of CKD

CKD is defined by an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Estimates are based on single estimates of eGFR and UACR.

Estimated glomerular filtration rate (eGFR)

Based on the CKD-EPI (2021) equation for calibrated creatinine: eGFR=142 x [min(serum creatinine in mg/dL) /κ, 1)]**α x [max(serum creatinine/κ, 1)]**-1.20 x 0.9938**age x (1.012 if female).

κ = 0.7 if female and 0.9 if male
α = -0.241 if female and -0.302 if male
** = raise to the power

Albuminuria

UACR is calculated as urine albumin divided by urine creatinine. Albuminuria is defined as UACR ≥ 30 mg/g.

Serum Creatinine

Serum creatinine values used for eGFR calculation are standardized against isotope dilution mass spectrometry (IDMS).

Urine Albumin

Measured in random urine collection by fluorescent immunoassay.

Limitations of Indicator

Functional limitations are self-reported. Albuminuria and kidney function are assessed from one-time cross-sectional measurements, possibly overestimating CKD prevalence. 

Analytical Considerations

Appropriate NHANES survey weights are used for all analyses; if the relative standard error is greater than 30%, the estimates are not shown. Serum creatinine measurements are assay corrected for NHANES years 2005 and 2006 and prior to be combined with later years.

  • U.S. Department of Health and Human Services. U.S. Department of Health and Human Services Implementation Guidance on Data Collection Standards for Race, Ethnicity, Sex, Primary Language, and Disability status. 2011.
    http://aspe.hhs.gov/datacncl/standards/ACA/4302