National Long Term Care Survey (*)

The NLTCS was designed to measure disability and the use of long-term care (LTC) among the U.S. elderly (age 65+) population at multiple points in time from 1982 to 2004. The cumulative sample size over the six survey years (waves) was 49,258 distinct persons, all of whom were enrolled in the Medicare program. The NLTCS is a nationally-representative sample that includes both community and institutionalized populations. It is also longitudinal as the sample individuals joined the survey once they reach 65 years of age (except for 1982 where ages above 65 were represented) and remained in the survey until they either died or were lost to follow-up. 

The six survey years were 1982, 1984, 1989, 1994, 1999 and 2004. Each wave consisted of a telephone screener interview, followed by an in-person detailed interview for those respondents who met various disability screening criteria (designated as “screen-ins”). In-person screening visits were also conducted for those respondents who could not be contacted by telephone, followed by detailed interviews for those who screened-in. The number of persons who completed the screener interviews defined the cross-sectional sample size for each survey year, which was in the range of 16,000–21,000, with approximately 6,000–7,500 detailed in-person interviews for persons who met various disability screening criteria.

Detailed interviews were conducted for both community and institutional residents during all survey years except for 1982, when institutionalization was noted without further information being collected. The institutional detailed interview was a shortened, modified form of the community detailed interview with sample sizes in the range 970–1,770 for the period of 1984–2004. Disability measures included: need for help with basic and instrumental activities of daily living (abbreviated as ADLs and IADLs, respectively), whose duration had lasted or was expected to last 3+ months; and cognitive impairment (CI) and institutionalization in a nursing home or similar LTC facility. During the later waves of the NLTCS, the options for residing in an assisted living community (ALC) expanded substantially. Approximately half of the ALC residents in 2004 were classified as institutionalized in a nursing home or similar type of health-care facility.

Consisting of total sample sizes of close to 20,000 for each survey year, and multiple waves of similar size and face-to-face assessments plus Medicare record linkages, the NLTCS database is an unparalleled resource on aging and disability in the U.S. The NLTCS multi-wave database provides data on prevalence and patterns of both physical and cognitive limitations, as well as detailed information for each respondent regarding health care services used, demographic and economic characteristics and health costs and expenditures.

Data Collection Category
Longitudinal Surveys
Last Year of Data
Birth Year
Age Range at Last Data Collection
Biomarkers/ Administrative or Other Data Elements
Primary Funding Agency
Duke Principal Investigator(s)