The rapid increase in reported prevalence of disability and handicap during the 1980s has evoked concern over the possible implications for disability services. This paper examines the variations in prevalence of disability, handicap and severe handicap, reported in three population surveys over a period of twelve years, using standardisation to control for the effect of changes in population age structure. A decomposition is applied to clarify the relative contributions of changes in population age structure and reported age-specific prevalence rates to the overall reported prevalence of disability. The analysis suggests that the age standardised prevalence of severe handicap has remained fairly steady since 1981. Between 1981 and 1993 increases in reported prevalence of severe handicap were mainly due to population ageing. A possible increase in multiple areas of handicap is suggested by the increases in mean number of total reported areas of handicap per person and in proportions of people reporting specific areas of handicap. The implications of these findings for service planning are explored.