National longitudinal surveys of aging and health frequently use self-reported ability to conduct activities of daily living (ADLs, such as bathing and toileting) and instrumental activities of daily living (IADLs, such as preparing meals and managing money) to measure disability in the population. Several analyses of these data found that disability declined in the 1990s. Changes in rates of reported difficulty with ADLs and IADLs are often interpreted as indicators of changes in the health status of the elderly population.

Some of the observed decline in self-reported disability may, however, be attributable to increased use of factors that reduce task demand, such as assistive technologies and home modifications. Even in surveys that ask about ability without help, respondents may not perceive these technologies and modifications as help, but rather the usual way these I ndividuals conduct their tasks. In addition, technologies that diffused throughout the population over time, such as automated banking and microwaves, may facilitate many ADLs and IADLs for all individuals. Behavioral changes attributable to loss of physical functioning, such as washing clothes in the sink rather than doing a load of laundry, may also reduce task demand. If availability and use of technologies and home and behavioral modifications decreases respondents’ propensity to report disability, our current understanding of the health status of the elderly population will be incomplete.

We have conducted an innovative pilot survey of 441 community-dwelling elderly in the Boston area. The survey included standard survey items measuring functioning problems walking around inside, grocery shopping, and preparing meals; questions about use of specific technologies and other forms of assistance for these tasks; anchoring vignettes, which asked respondents to rate the disability status of hypothetical people with varying levels of functioning using the same scale as the self-assessment; and objective measures of physical functioning. The specific aims of this project are to:

• test whether use of various technologies and environmental factors were important determinants of self-reported disability in survey items measuring functioning problems walking around inside, grocery shopping, and preparing meals, conditional on objective measures of functioning;

• evaluate whether anchoring vignettes, a new survey technique, identified systematic differences in self-reported disability walking and grocery shopping among elderly survey respondents.