Heterogeneity and the determinants of multidimensional health transition among Chinese middle-aged and older people: a person-centered approach

IntroductionPrevious health transition patterns studies only focused on biological and psychological dimensions, and overlooked social dimension. By combining biological, psychological, and social health dimensions, this study aimed to examine heterogeneous transition patterns and assessed their det...

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Main Authors: Linglong Ye, Zhengman Wu, Yi-Wei Kao, Jianping Zhu, Mingchih Chen, Ben-Chang Shia, Lei Qin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1563419/full
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author Linglong Ye
Zhengman Wu
Yi-Wei Kao
Jianping Zhu
Jianping Zhu
Jianping Zhu
Mingchih Chen
Ben-Chang Shia
Ben-Chang Shia
Lei Qin
Lei Qin
author_facet Linglong Ye
Zhengman Wu
Yi-Wei Kao
Jianping Zhu
Jianping Zhu
Jianping Zhu
Mingchih Chen
Ben-Chang Shia
Ben-Chang Shia
Lei Qin
Lei Qin
author_sort Linglong Ye
collection DOAJ
description IntroductionPrevious health transition patterns studies only focused on biological and psychological dimensions, and overlooked social dimension. By combining biological, psychological, and social health dimensions, this study aimed to examine heterogeneous transition patterns and assessed their determinants among Chinese middle-aged and older adults.MethodsFour waves of longitudinal data in 2011–2012, 2013, 2015, and 2018 from the China Health and Retirement Longitudinal Study was adopted. A total of 6,161 adults aged ≥45 years with no missing data on three dimensions were included. The repeated-measures latent class analysis as a person-centered approach was used to estimate transition patterns, followed by multinomial logistic regression to assess determinants.ResultsThis study highlighted five health transition groups, including “social participation slightly improving followed by deterioration” (SP-ID, 23.62%), “cognitive status deteriorating gradually and lacking social participation” (CS-DG&L-SP, 17.97%), “ADLs deteriorating followed by a slight improvement and lacking social participation” (ADLs-DI&L-SP, 9.14%), “died in the follow-up period” (DIFP, 11.65%), and “sustainedly healthy” (SH, 37.62%). Using the SH group as the reference group, sex, education, job, type of residence, and region have different impact on different patterns. Men were more likely to be in the SP-ID and DIFP groups, while women were more likely to be in the CS-DG&L-SP and ADLs-DI&L-SP groups. Being not in marriage was related to the SP-ID, CS-DG&L-SP, and DIFP groups. Those living in the central region and those having smoking and drinking habits less tended to fall into the SP-ID group. The retired, non-smokers, and drinkers even less tended to be in the CS-DG&L-SP group. Those living in the eastern region, those drinking alcohol appropriately, and those with higher income less tended to be in the ADLs-DI&L-SP group. Being uninsured by public insurance and having lower income were associated with the DIFP group.ConclusionIntegrating the social dimension with physical and psychological dimensions enhanced our understanding of the heterogeneous health transition patterns of middle-aged and older people. These findings provide valuable evidence for promoting healthy aging targets for different groups of the aging population.
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spelling doaj-art-2063d5478cbd4d1d8da55d2f903cae7f2025-08-20T02:48:18ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15634191563419Heterogeneity and the determinants of multidimensional health transition among Chinese middle-aged and older people: a person-centered approachLinglong Ye0Zhengman Wu1Yi-Wei Kao2Jianping Zhu3Jianping Zhu4Jianping Zhu5Mingchih Chen6Ben-Chang Shia7Ben-Chang Shia8Lei Qin9Lei Qin10School of Public Affairs, Xiamen University, Xiamen, ChinaSchool of Public Affairs, Xiamen University, Xiamen, ChinaDepartment of Applied Statistics and Information Science, Ming Chuan University, Taoyuan, TaiwanNational Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, ChinaData Mining Research Center, Xiamen University, Xiamen, ChinaSchool of Management, Xiamen University, Xiamen, ChinaGraduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City, TaiwanGraduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City, TaiwanArtificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City, TaiwanSchool of Statistics, University of International Business and Economics, Beijing, ChinaDong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, ChinaIntroductionPrevious health transition patterns studies only focused on biological and psychological dimensions, and overlooked social dimension. By combining biological, psychological, and social health dimensions, this study aimed to examine heterogeneous transition patterns and assessed their determinants among Chinese middle-aged and older adults.MethodsFour waves of longitudinal data in 2011–2012, 2013, 2015, and 2018 from the China Health and Retirement Longitudinal Study was adopted. A total of 6,161 adults aged ≥45 years with no missing data on three dimensions were included. The repeated-measures latent class analysis as a person-centered approach was used to estimate transition patterns, followed by multinomial logistic regression to assess determinants.ResultsThis study highlighted five health transition groups, including “social participation slightly improving followed by deterioration” (SP-ID, 23.62%), “cognitive status deteriorating gradually and lacking social participation” (CS-DG&L-SP, 17.97%), “ADLs deteriorating followed by a slight improvement and lacking social participation” (ADLs-DI&L-SP, 9.14%), “died in the follow-up period” (DIFP, 11.65%), and “sustainedly healthy” (SH, 37.62%). Using the SH group as the reference group, sex, education, job, type of residence, and region have different impact on different patterns. Men were more likely to be in the SP-ID and DIFP groups, while women were more likely to be in the CS-DG&L-SP and ADLs-DI&L-SP groups. Being not in marriage was related to the SP-ID, CS-DG&L-SP, and DIFP groups. Those living in the central region and those having smoking and drinking habits less tended to fall into the SP-ID group. The retired, non-smokers, and drinkers even less tended to be in the CS-DG&L-SP group. Those living in the eastern region, those drinking alcohol appropriately, and those with higher income less tended to be in the ADLs-DI&L-SP group. Being uninsured by public insurance and having lower income were associated with the DIFP group.ConclusionIntegrating the social dimension with physical and psychological dimensions enhanced our understanding of the heterogeneous health transition patterns of middle-aged and older people. These findings provide valuable evidence for promoting healthy aging targets for different groups of the aging population.https://www.frontiersin.org/articles/10.3389/fmed.2025.1563419/fullaginghealth transitionheterogeneitymultidimensional healthrepeated-measures latent class analysis
spellingShingle Linglong Ye
Zhengman Wu
Yi-Wei Kao
Jianping Zhu
Jianping Zhu
Jianping Zhu
Mingchih Chen
Ben-Chang Shia
Ben-Chang Shia
Lei Qin
Lei Qin
Heterogeneity and the determinants of multidimensional health transition among Chinese middle-aged and older people: a person-centered approach
Frontiers in Medicine
aging
health transition
heterogeneity
multidimensional health
repeated-measures latent class analysis
title Heterogeneity and the determinants of multidimensional health transition among Chinese middle-aged and older people: a person-centered approach
title_full Heterogeneity and the determinants of multidimensional health transition among Chinese middle-aged and older people: a person-centered approach
title_fullStr Heterogeneity and the determinants of multidimensional health transition among Chinese middle-aged and older people: a person-centered approach
title_full_unstemmed Heterogeneity and the determinants of multidimensional health transition among Chinese middle-aged and older people: a person-centered approach
title_short Heterogeneity and the determinants of multidimensional health transition among Chinese middle-aged and older people: a person-centered approach
title_sort heterogeneity and the determinants of multidimensional health transition among chinese middle aged and older people a person centered approach
topic aging
health transition
heterogeneity
multidimensional health
repeated-measures latent class analysis
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1563419/full
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