Longitudinal trajectories of disability index and associated factors in Chinese older adults

Background: As the global population ages, understanding the trajectories of disability in older adults is crucial for improving health outcomes and quality of life. This study aimed to identify patterns of disability index trajectories and associated factors influencing these trajectories in older...

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Main Authors: Huaxin Si, Yemin Yuan, Zhenyu Shi, Yanshang Wang, Ping He
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:The Journal of Nutrition, Health and Aging
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Online Access:http://www.sciencedirect.com/science/article/pii/S1279770725000533
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author Huaxin Si
Yemin Yuan
Zhenyu Shi
Yanshang Wang
Ping He
author_facet Huaxin Si
Yemin Yuan
Zhenyu Shi
Yanshang Wang
Ping He
author_sort Huaxin Si
collection DOAJ
description Background: As the global population ages, understanding the trajectories of disability in older adults is crucial for improving health outcomes and quality of life. This study aimed to identify patterns of disability index trajectories and associated factors influencing these trajectories in older adults. Methods: A total of 3,227 older adults aged 60 years and older were recruited from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018). We used group-based trajectory model to jointly estimate trajectories of disability index and attrition probability, while assessing baseline factors associated with the trajectory membership. Results: Our findings revealed four distinct trajectories of disability index: slightly limited-gradual deterioration (n = 1661, 51.5%), fluctuating change (n = 588, 18.2%), slightly limited-substantial deterioration (n = 397, 12.3%), and stable severely limited (n = 581, 18.0%). Women, unmarried, lower educational level, living in rural areas, no pension, comorbidity, poor self-rated health, a history of falls, short sleep duration, inadequate social activity, weakness, slowness, and poor chair standing were significantly associated with a higher probability of being in poorer disability index trajectories. Conclusions: This study highlights the heterogeneity of disability index trajectories in older adults and the multifaceted factors that influence them. Our findings underscore the importance of targeting early prevention or intervention based on the determinants of these trajectories to individual needs to maintain or delay the rate of deterioration of disability in older adults.
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spelling doaj-art-fdccc4ce649b456f8b6f09e297226a0e2025-08-20T03:52:04ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882025-05-0129510053010.1016/j.jnha.2025.100530Longitudinal trajectories of disability index and associated factors in Chinese older adultsHuaxin Si0Yemin Yuan1Zhenyu Shi2Yanshang Wang3Ping He4School of Public Health, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China; China Center for Health Development Studies, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, ChinaSchool of Public Health, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China; China Center for Health Development Studies, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, ChinaSchool of Public Health, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China; China Center for Health Development Studies, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, ChinaSchool of Public Health, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China; China Center for Health Development Studies, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, ChinaChina Center for Health Development Studies, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China; Corresponding author.Background: As the global population ages, understanding the trajectories of disability in older adults is crucial for improving health outcomes and quality of life. This study aimed to identify patterns of disability index trajectories and associated factors influencing these trajectories in older adults. Methods: A total of 3,227 older adults aged 60 years and older were recruited from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011–2018). We used group-based trajectory model to jointly estimate trajectories of disability index and attrition probability, while assessing baseline factors associated with the trajectory membership. Results: Our findings revealed four distinct trajectories of disability index: slightly limited-gradual deterioration (n = 1661, 51.5%), fluctuating change (n = 588, 18.2%), slightly limited-substantial deterioration (n = 397, 12.3%), and stable severely limited (n = 581, 18.0%). Women, unmarried, lower educational level, living in rural areas, no pension, comorbidity, poor self-rated health, a history of falls, short sleep duration, inadequate social activity, weakness, slowness, and poor chair standing were significantly associated with a higher probability of being in poorer disability index trajectories. Conclusions: This study highlights the heterogeneity of disability index trajectories in older adults and the multifaceted factors that influence them. Our findings underscore the importance of targeting early prevention or intervention based on the determinants of these trajectories to individual needs to maintain or delay the rate of deterioration of disability in older adults.http://www.sciencedirect.com/science/article/pii/S1279770725000533Disability indexTrajectoriesProspective cohort studyGroup-based trajectory model
spellingShingle Huaxin Si
Yemin Yuan
Zhenyu Shi
Yanshang Wang
Ping He
Longitudinal trajectories of disability index and associated factors in Chinese older adults
The Journal of Nutrition, Health and Aging
Disability index
Trajectories
Prospective cohort study
Group-based trajectory model
title Longitudinal trajectories of disability index and associated factors in Chinese older adults
title_full Longitudinal trajectories of disability index and associated factors in Chinese older adults
title_fullStr Longitudinal trajectories of disability index and associated factors in Chinese older adults
title_full_unstemmed Longitudinal trajectories of disability index and associated factors in Chinese older adults
title_short Longitudinal trajectories of disability index and associated factors in Chinese older adults
title_sort longitudinal trajectories of disability index and associated factors in chinese older adults
topic Disability index
Trajectories
Prospective cohort study
Group-based trajectory model
url http://www.sciencedirect.com/science/article/pii/S1279770725000533
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AT yanshangwang longitudinaltrajectoriesofdisabilityindexandassociatedfactorsinchineseolderadults
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