Limited but not Disabled: Subjective Disability Versus Objective Measurement of Functional Status and Mortality Risk Among Elderly Mexican Americans

In this paper, we examine the degree of concordance among subjective and more objective measures of functional capacity and disability among older Mexican-origin Hispanics. We address three questions: (1) Are there significant discrepancies between objectively measured functional limitations and self-reported disability? (2) How is mortality affected by discrepancies between self-reported disability and more objective functional limitations? (3) Finally, is the association between discrepancies and mortality affected by psychological, cultural, and social factors net of physical illness? We use data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly Waves 1 and 5 (N = 863). We examine individuals who have objective functional limitations measured by POMAs and label those who also report having ADL disability as “Realists” while those who report no ADLs are labeled “Optimists.” Results show that the association between “optimism” and mortality is mediated by differences in the number and degree of severity of IADL disabilities and the independent living capacities these measures represent.