Chapter 2 - Adults with impairment at both waves, Life Opportunities Survey - Wave Two Report, Part 1

Chapter 2 – Adults with impairment at both waves

Of adults who reported at least one impairment at Wave One, two thirds (66 per cent) reported having at least one impairment in Wave Two (impairment at both waves). The remaining 34 per cent of adults who had an impairment at Wave One no longer reported any impairment at Wave Two, they have offset from impairment and these adults will be discussed in Chapter Three.

This chapter focuses on all adults who had at least one impairment at both Wave One and Wave Two.

2.1 Impairments reported by adults with an impairment at both waves at Wave Two

This section describes the impairments that adults with an impairment at both waves experienced at both Wave One and Wave Two.

For adults with impairment at both waves, there has been little change between the two waves in terms of the number of impairments they reported. Consequently, only results from Wave Two are presented for this analysis. Figure 2.1 shows the percentage breakdown of these adults by the number of impairments they reported at Wave Two, and by age¹.

Overall, adults with impairment at both waves were more likely to report three or more impairments (44 per cent) than only one impairment (33 per cent) at Wave Two. Those aged 65 or over in this group were also more likely to have three or more impairments (50 per cent) than those of working age (aged 16 to 64, at 41 per cent). Adults aged 65 or over were also less likely to have only one impairment (26 per cent) than adults of working age (37 per cent).

Figure 2.1 Impairment at both waves: Number of impairments reported at Wave Two (by age)

Notes:

1. Source - LOS Wave Two Longitudinal Dataset, Office for National Statistics

Download chart

• XLS format
  (27.5 Kb)

Figure 2.2 shows the overall distribution of impairment types at Wave One and Wave Two for adults with impairments at both waves. For both waves, the most commonly-reported impairments were long-term pain (67 per cent at Wave One and 66 per cent at Wave Two) and chronic health condition² (53 and 52 per cent), followed by mobility (38 and 39 per cent) and dexterity (25 and 24 per cent) impairments. Intellectual (2 and 2 per cent) and behavioural (4 and 3 per cent) impairments were those least likely to have been reported.

Between Wave One and Wave Two, the impairment types reported by adults were liable to change. That is, the adults reporting a particular impairment type at Wave One will not necessarily be the same group of adults reporting that impairment type at Wave Two. Further explanations on the changes of impairment types reported by this group are provided in Section 2.3.

Figures 2.3 and 2.4 show the percentage of those with impairment at both waves who had reported each impairment, by working age (16 to 64) and those aged 65 or over. As with Figure 2.2, for both age groups, there has been little change between the two waves in the percentage who reported having each of the impairments.

When the percentages of working age adults and adults aged 65 or over reporting each impairment are compared (see Figure 2.5), there are some significant differences. A higher percentage of those aged 65 or over than those of working age reported a mobility impairment (51 per cent and 30 per cent respectively) and a hearing impairment (17 per cent and 7 per cent respectively) at Wave Two. On the other hand, a higher percentage of those of working age than those aged 65 or over reported a mental health condition (22 per cent and 4 per cent respectively) and a learning impairment (10 per cent and 1 per cent respectively) at Wave Two.

Figure 2.2 Impairment at both waves: Impairment types reported at Wave One and Wave Two

Notes:

1. Source - LOS Wave Two Longitudinal Dataset, Office for National Statistics

Download chart

• XLS format
  (28 Kb)

Figure 2.3 Impairment at both waves: Impairment types reported at Wave One and Wave Two, adults aged 16-64

Notes:

1. Source - LOS Wave Two Longitudinal Dataset, Office for National Statistics

Download chart

• XLS format
  (31 Kb)

Figure 2.4 Impairment at both waves: Impairment types reported at Wave One and Wave Two, adults aged 65 or over

Notes:

1. Source - LOS Wave Two Longitudinal Dataset, Office for National Statistics

Download chart

• XLS format
  (29 Kb)

Figure 2.5 Impairment at both waves: Impairment types reported at Wave Two, by age

Notes:

1. Source - LOS Wave Two Longitudinal Dataset, Office for National Statistics

Download chart

• XLS format
  (29 Kb)

Notes for 2.1 Impairments reported by adults with an impairment at both waves at Wave Two

1. In this report, all analyses comparing between those of working age (16-64) and those aged 65 or over are based on respondents’ age at Wave One.
2. Chronic Conditions are defined as long-term conditions that have lasted or are expected to last 12 months or more and that have been diagnosed by a health professional. These include but are not limited to: Asthma or severe allergies; Heart condition or disease; Kidney condition or disease; Cancer; Diabetes; Epilepsy; Cerebral Palsy; Spina Bifida; Cystic Fibrosis; Muscular Dystrophy; Migraines; Arthritis or rheumatism; Multiple Sclerosis (MS) ; Paralysis of any kind; and Depression;

2.2 Severity of impairment reported by adults with impairment at both waves

The severity of impairment can be reflected by the level of difficulty¹ and frequency of the limitation associated with the impairment. Tables 2.1 to 2.4 present the level of severity reported at Wave Two for the four most commonly-reported impairments by adults with impairment at both waves² (long-term pain, chronic health conditions, mobility and dexterity). Details of the level and frequency of other impairment or health condition types can be found in Appendix One, and the corresponding figures for Wave One can be found in Appendix Two.

For all four impairment types, approximately two-thirds of adults with an impairment at both waves reported moderate difficulty for that impairment. A greater proportion of adults aged 65 or over with long-term pain “always” experienced limitation (35 per cent), compared with adults of working age (28 per cent). This was also true for chronic health condition (53 and 45 per cent respectively) but not for mobility or dexterity impairments.  Overall 53 per cent of those with a mobility impairment reported that they ‘always’ experienced limitation – the highest measure among these four impairment types.

Table 2.1, Impairment at both waves: severity of long-term pain at Wave Two, by age

Table source: Office for National Statistics

Table notes:

1. ¹ Level of pain for long-term pain is measured by the intensity of pain – “mild”, “moderate”, or “severe”. Under the LOS definition, those who reported moderate or severe levels of pain, and rated the frequency of limitation as “rarely” or above were identified as having long-term pain

Table 2.2, Impairment at both waves: severity of chronic health condition at Wave Two, by age

Table source: Office for National Statistics

Table notes:

1. ¹ Response categories for level of difficulty: 1. “No Difficulty”; 2. “Mild Difficulty”; 3. Moderate Difficulty 4; “Severe Difficulty”; and 5. “Cannot Do”; For some impairment types (chronic condition, breathing, learning, intellectual, behavioural, memory, and mental impairments), the levels range from 1 to 4. For pain, the level of pain is measured by the intensity of the pain experienced: 1.”Mild”; 2.”Moderate”; 3. “Severe”.
2. * Value suppressed due to small sample size

Table 2.3, Impairment at both waves: severity of mobility Impairment at Wave Two, by age

Table source: Office for National Statistics

Table notes:

1. ¹ Response categories for level of difficulty: 1. “No Difficulty”; 2. “Mild Difficulty”; 3. Moderate Difficulty 4; “Severe Difficulty”; and 5. “Cannot Do”; For some impairment types (chronic condition, breathing, learning, intellectual, behavioural, memory, and mental impairments), the levels range from 1 to 4. For pain, the level of pain is measured by the intensity of the pain experienced: 1.”Mild”; 2.”Moderate”; 3. “Severe”.
2. *Value suppressed due to small sample size.

Table 2.4, Impairment at both waves: severity of dexterity impairment at Wave Two, by age

Table source: Office for National Statistics

Table notes:

1. ¹ Response categories for level of difficulty: 1. “No Difficulty”; 2. “Mild Difficulty”; 3. Moderate Difficulty 4; “Severe Difficulty”; and 5. “Cannot Do”; For some impairment types (chronic condition, breathing, learning, intellectual, behavioural, memory, and mental impairments), the levels range from 1 to 4. For pain, the level of pain is measured by the intensity of the pain experienced: 1.”Mild”; 2.”Moderate”; 3. “Severe”.
2. *Value suppressed due to small sample size.

Tables 2.5 to 2.8 present the change in level of difficulty and frequency of limitation for the four most common impairment types³ (long-term pain, chronic health condition, mobility and dexterity) between Waves One and Two. Change here is defined simply as an increase or decrease in level and frequency. It is important to note that this analysis does not give information about the magnitude of change in severity, only that the level and frequency of limitation has decreased, stayed the same, or increased between Wave One and Wave Two. For example, both an increase from moderate to severe difficulty and an increase from moderate difficulty to ‘cannot do’ will be classed as an increase in the level of severity. This analysis defines an adult as having a particular impairment if they report a level of difficulty greater than mild⁴ and report some limitation. The analysis presented below only includes those who have been classified as having that impairment type at both Wave One and Wave Two⁵.

For each of these impairment types, almost half of adults with impairment at both waves experienced no change in the frequency of limitation posed by the impairment. Around two-thirds of those who had the same impairment at both Wave One and Wave Two reported no change in the level of pain experienced due to the impairment. No clear pattern of increase or decrease in the level of severity is evident for these four impairment types. There is also very little difference between age groups in terms of the changes of severity they experienced.

For each of these impairment types, around 30 per cent of all adults with an impairment at both waves experienced no change in both the level or frequency of the impairment. Where a change was experienced it was more likely to be a change in the frequency of limitation rather than a change in the level of pain.

Table 2.5, Impairment at both waves: change in severity of long-term pain, by age

Table source: Office for National Statistics

Table notes:

1. ¹ Level of pain for long-term pain is measured by the intensity of pain – “mild”, “moderate”, or “severe”. Under the LOS definition, those who reported moderate or severe levels of pain, and rated the frequency of limitation as “rarely” or above were identified as having long-term pain.

Table 2.6, Impairment at both waves: change in severity of chronic health condition, by age

Table source: Office for National Statistics

Table 2.7, Impairment at both waves: change in severity of mobility impairment, by age

Table source: Office for National Statistics

Table 2.8, Impairment at both waves: change in severity of dexterity Impairment, by age

Table source: Office for National Statistics

Notes for 2.2 Severity of impairment reported by adults with impairment at both waves

1. Response categories for level of difficulty: 1. “No Difficulty”; 2. “Mild Difficulty”; 3. Moderate Difficulty 4; “Severe Difficulty”; and 5. “Cannot Do”; For some impairment types (chronic condition, breathing, learning, intellectual, behavioural, memory, and mental health impairments), the levels range from 1 to 4. For pain, the level of pain is measured by the intensity of the pain experienced: 1.”Mild”; 2.”Moderate”; 3. “Severe”.
2. Analysis in Tables 2.1 -2.4 is based upon only adults who reported the same impairment at both waves.
3. The corresponding tables for other impairment or health condition types can be found in Appendix Three.
4. Response categories for level of difficulty: 1. “No Difficulty”; 2. “Mild Difficulty”; 3. Moderate Difficulty 4; “Severe Difficulty”; and 5. “Cannot Do”; For some impairment types (chronic condition, breathing, learning, intellectual, behavioural, memory, and mental health impairments), the levels range from 1 to 4. For pain, the level of pain is measured by the intensity of the pain experienced: 1.”Mild”; 2.”Moderate”; 3. “Severe”.
5. And therefore reported the level of difficulty as greater than ‘mild’ at both waves.

2.3 Changes in impairment among adults with an impairment at both waves

Adults are classified as having an impairment at both waves if they had at least one impairment at Wave One and at Wave Two. While some members of this group reported the same impairments at both waves, others may have reported a different set of impairments at Wave One and Wave Two. In other words, adults may report an impairment at Wave Two that was not recorded at Wave One, this impairment may replace an impairment reported at Wave One, or may be in addition to any impairments reported at Wave One.

Conversely, some adults with impairment at both waves may report an impairment at Wave One, but no longer reported that same impairment at Wave Two. For example, suppose that someone reported a mobility and a dexterity impairment at Wave One. If at Wave Two this person no longer reported the dexterity impairment (but still reported the mobility impairment), then he/she would experience an offset of dexterity impairment but still be classified as having an impairment at both waves.

Impairments are based on self-reporting, and there are many reasons for onset and offset (for example, improvements in medication or carer assistance). At Wave Two the LOS did not ask reasons for onset or offset of impairments, however at Wave Three the LOS questionnaire will ask for more details about the onset or offset from impairment that is reported and will therefore aim to offer greater insight into the reasons for changes in impairment.

Tables 2.9 and 2.10 describe changes in impairment type reported by adults who had impairment at both waves. The offset rate presented in Table 2.9 is the percentage of adults with impairment at both waves who reported a particular impairment type at Wave One but did not report that same impairment type at Wave Two^1,2. The ‘Additional Impairment Onset Rate’ in Table 2.10 is the percentage of adults with impairment at both waves who did not report a particular impairment type at Wave One³ but did report that impairment type at Wave Two⁴.

The offset rate for some impairments and for certain age groups have been suppressed due to both small sample sizes and large standard errors (and hence wide confidence intervals).

Generally, however, the figures in Table 2.9 indicate that for this group of adults with impairment at both waves, there was a great deal of change in the types of impairments reported between Wave One and Wave Two, with substantial proportions of this group no longer reporting a particular impairment at Wave Two, after reporting it at Wave One. Impairments identified by LOS are self-reported⁵, it may be that the perception of the impairment has changed rather than there being a real change in the situation. This might be due to a genuine cessation of the impairment, or it could be due to a change in classification of the impairment (to another category). Reasons for offset will be explored further with the Wave Three questionnaire.

The three most common impairment types (long-term pain, chronic health condition and mobility) also have the lowest offset rates among adults with impairment at both waves (19, 34 and 34 per cent respectively). This finding suggests that for adults with impairment at both waves, the likelihood of these adults offsetting from long-term pain, chronic health condition and mobility impairment at Wave Two is lower than for other impairment or health condition types. It may also be that because adults with impairment at both waves have an older age distribution than the general population, these adults have an increased likelihood of having these impairments⁶. Therefore, it is not surprising that these three impairments show the lowest offset rates among adults who continue to have an impairment. This could also explain the high onset rates for these three impairments among adults with impairment at both waves.

Table 2.9, Impairment at both waves: offset rate by impairment type and age<1>

Table source: Office for National Statistics

Table notes:

1. ¹ See Appendix 8 for sample sizes.
2. * Value is suppressed due to small sample size.

Table 2.10, Impairment at both waves: onset rate by impairment type and age<1>

Table source: Office for National Statistics

Table notes:

1. ¹ See Appendix 8 for sample sizes.

Notes for 2.3 Changes in impairment among adults with an impairment at both waves

1. And therefore reported a different impairment at Wave Two.
2. This will include those who reported “mild” difficulty for an impairment at Wave Two but higher level of difficulty for Wave One.
3.  But did report some other impairment or health condition at Wave One.
4. This will include those who reported “mild” difficulty for an impairment at Wave One but higher level of difficulty for Wave Two.
5. See Section 1.6 for specific strengths and weaknesses of LOS
6. See Annex 1 Table An.2

Background notes

1. Details of the policy governing the release of new data are available by visiting www.statisticsauthority.gov.uk/assessment/code-of-practice/index.html or from the Media Relations Office email: media.relations@ons.gsi.gov.uk