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AI/AN Age and Disability

Guidance for the American Indians and Alaska Natives population, including information on age, disability and their increased need for long term services and supports for their elders and tribal members with disabilities.


Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: June 22, 2016

Older American Indians and Alaska Natives are a rapidly growing population group.

  • By 2020, the number of AI/AN people 65 and older will be 75% higher than it was in 2010, according to the Administration on Aging.
  • While tribes may understand elderhood as beginning at a different age, this website defines "older adults" as age 65 and older, because Medicare eligibility begins at age 65 and because many national statistics (like the Census) use age 65 as a cutoff.

AI/AN populations also face disability at a rate higher than other racial groups.

  • The Centers for Disease Control and Prevention found that Native people overall are 50.3% more likely to have a disability, when compared to the national average.1
  • A large study of individual-level data on individuals 55 years and older examined the prevalence rates of functional limitation, mobility disability, and self-care disability. It found that AI/AN people had the highest prevalence rates of functional limitations compared to either African Americans or Whites, and higher rates of all three disability types than Whites.2

Overall, AI/AN populations experience some of the highest rates of chronic disease and disability in the U.S.3 Due to the increase in the AI/AN older population and the high level of disability within this population and among younger people, tribal communities are experiencing an increased need for long-term services and supports for their elders and tribal members with disabilities.

1 Centers for Disease Control and Prevention (2008). Racial/Ethnic Disparities in Self-Rated Health Status Among Adults With and Without Disabilities—United States, 2004-2006. Morbidity and Mortality Weekly Report Weekly, 57(39), 1069-1073. Available online at

2 Goins, R. T., Moss, M., Buchwald, D., & Guralnik, J. M. (2007). Disability among older American Indians and Alaska Natives: an analysis of the 2000 Census public use microdata sample. The Gerontologist, 47(5), 690-696. Available online at

3 Goins, R. T., Bogart, A., & Roubideaux, Y. (2010). Service Provider Perceptions of Long-Term Care Access in American Indian and Alaska Native Communities. Journal of Health Care for the Poor and Underserved, 21(4), 1340-1351.

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.