The Importance of Recognizing Disability in Midlife: Questions and Answer

Disability during one's midlife is an important topic. The guest editors for BMC's Women's Midlife Health discuss why they made this the topic of the journal's latest thematic series in a Q&A.

The BMC Journal, Women’s Midlife Health, is running a thematic series titled “Disability in Midlife.” The series aims to highlight women in this specific subgroup. Recently, the blog team at BMC got a chance to speak with the series’ guest editors, Dr. Carrie Karvonen-Guitierrez, from The University of Michigan School of Public Health and Elsa Strotmeyer from the University of Pittsburgh, about the blog. There is currently an open Call For Papers for all those who would like to submit to the series.

How did the idea for this thematic series come about? What was the inspiration?

Disability and limitations in functioning have historically been predominantly studied among populations of older adults, however, several recent studies have suggested that not only is the prevalence of disability high among mid-life adults (20-40%), but that over the last several years, the burden has been increasing among this demographic.

Why do you think it’s important to have “disability in midlife” as a focus for further attention?

While disability and functioning have been intensively studied among populations of older adults, less research has been done on these issues in mid-life populations. The metrics and considerations for research of disability and functioning among mid-life adults may differ in meaningful ways from currently accepted practices. For example, the traditional model of the disablement process is based upon medical pathologies as the initiating factor toward disablement. Among mid-life adults, however, disability may emerge as a more contextual feature, present only when situated with other factors including genetic or biological factors but also behavioral, social, or economic factors. Thus, disability studies among mid-life adults may need to be more comprehensive in scope and consideration of the varied ways in which the environment or coping strategies may impact one’s functioning.

Further, given that mid-aged adults are often still in the workforce and may be caring for dependent children and/or aging parents, understanding issues of disability and functioning among this demographic is critical to being able to develop interventions and strategies to promote overall wellness, functioning, and independence during this life stage.

In what ways do you believe that disability in midlife is distinct and different from disability in other life stages?

The burden of disability and functional limitations during this life stage is highly dynamic, meaning that individuals experiencing limitations still maintain a high probability of improving. This is a critically important finding because it suggests that this life-stage may be a critical window for intervention. Although individuals may experience limitations in function, they still maintain the capacity for improvement. Thus, identifying these limitations during mid-life is critical to initiating interventions for better functioning to promote wellness throughout mid-life and into late adulthood.

What are some of the major obstacles that may lower the quality of life in women with a disability in midlife?

Some include stress, such as job stress, caregiving stress, economic stress, and relationship stress. In addition, lack of appropriate or tailored interventions/therapy/etc. for situational disability or early decline in physical function during the mid-life contribute to life quality. Lack of appropriate policies and support (time off, insurance) to assist with needs related to situational disability may also contribute to quality of life.

What do you hope that the public will take away from reading this series?

We hope the public will recognize key issues related to health and physical functioning during mid-life. We also hope the public will consider ways to promote wellness and engage in activities known to prevent or forestall disability and poor functioning—physical activity is the major one.

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