TY - JOUR
T1 - Ethnicity and changing functional health in middle and late life
T2 - A person-centered approach
AU - Liang, Jersey
AU - Xu, Xiao
AU - Bennett, Joan M.
AU - Ye, Wen
AU - Quiñones, Ana R.
N1 - Funding Information:
This research was supported by the National Institute on Aging via grants AG154124 and AG028116 (J.L., principal investigator) and the National Institutes of health via a pilot grant (X.X., principal investigator) from the Michigan claude D. Pepper Older Americans Independence center (5P30AG024824) and the Michigan Institute of clinical and health Research (UL1RR024986). The Japanese Ministry of health, Labor and Welfare Longevity Foundation and the Tokyo Metropolitan Institute of Gerontology provided additional support.
PY - 2010
Y1 - 2010
N2 - Objectives.Following a person-centered approach, this research aims to depict distinct courses of disability and to ascertain how the probabilities of experiencing these trajectories vary across Black, Hispanic, and White middle-aged and older Americans. Methods.Data came from the 1995-2006 Health and Retirement Study, which involved a national sample of 18,486 Americans older than 50 years of age. Group-based semiparametric mixture models (Proc Traj) were used for data analysis. Results.Five trajectories were identified: (a) excellent functional health (61%), (b) good functional health with small increasing disability (25%), (c) accelerated increase in disability (7%), (d) high but stable disability (4%), and (e) persistent severe impairment (3%). However, when time-varying covariates (e.g., martial status and health conditions) were controlled, only 3 trajectories emerged: (a) healthy functioning (53%), moderate functional decrement (40%), and (c) large functional decrement (8%). Black and Hispanic Americans had significantly higher probabilities than White Americans in experiencing poor functional health trajectories, with Blacks at greater risks than Hispanics. Conclusions.Parallel to the concepts of successful aging, usual aging, and pathological aging, there exist distinct courses of changing functional health over time. The mechanisms underlying changes in disability may vary between Black and Hispanic Americans.
AB - Objectives.Following a person-centered approach, this research aims to depict distinct courses of disability and to ascertain how the probabilities of experiencing these trajectories vary across Black, Hispanic, and White middle-aged and older Americans. Methods.Data came from the 1995-2006 Health and Retirement Study, which involved a national sample of 18,486 Americans older than 50 years of age. Group-based semiparametric mixture models (Proc Traj) were used for data analysis. Results.Five trajectories were identified: (a) excellent functional health (61%), (b) good functional health with small increasing disability (25%), (c) accelerated increase in disability (7%), (d) high but stable disability (4%), and (e) persistent severe impairment (3%). However, when time-varying covariates (e.g., martial status and health conditions) were controlled, only 3 trajectories emerged: (a) healthy functioning (53%), moderate functional decrement (40%), and (c) large functional decrement (8%). Black and Hispanic Americans had significantly higher probabilities than White Americans in experiencing poor functional health trajectories, with Blacks at greater risks than Hispanics. Conclusions.Parallel to the concepts of successful aging, usual aging, and pathological aging, there exist distinct courses of changing functional health over time. The mechanisms underlying changes in disability may vary between Black and Hispanic Americans.
KW - Group-based mixture models
KW - Health disparities
KW - Minority aging (race/ethnicity)
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U2 - 10.1093/geronb/gbp114
DO - 10.1093/geronb/gbp114
M3 - Article
C2 - 20008483
AN - SCOPUS:77953646373
SN - 1079-5014
VL - 65 B
SP - 470
EP - 481
JO - Journals of Gerontology - Series B Psychological Sciences and Social Sciences
JF - Journals of Gerontology - Series B Psychological Sciences and Social Sciences
IS - 4
ER -