- 期刊
Education and Disability Trajectories among Older Adults in Taiwan: A Latent Class Growth Modeling Approach
並列摘要
Objective: Evaluating disability trajectories among older adults is important for gerontologists to understand the nature of late life course. The objectives of this study were to: (1) identify the disability trajectories of Taiwanese older adults; and (2) examine factors which might predict older adults to be in different disability trajectories. Methods: 3080 older adults were collected from a multiple waves Taiwan Longitudinal Study on Aging (TLSA) survey during 1996 to 2007. Disability trajectories modeled by activities of daily living (ADLs) and instrumental activities of daily living (IADLs) in older adults were identified using latent class growth curves modeling (LCGM). Older adults' demographics, physical conditions, health behaviors, and social relations at baseline were investigated to predict which disability trajectory older adults would enter in the following 11 years by applying multinomial logistic regression. Results: Three distinct disability trajectories were identified among older adults in Taiwan: health with maintained function (84.32%), early disability with maintained function (3.80%), and health with fast progressive disability (11.88%). For older adults who were younger, male, with less comorbidity, having leisure time physical activities (LTPAs), and better social contact at baseline were more likely to be classified into the trajectory of health with maintained function in the next 11 years. Those who were older, female, with more comorbidity, and having less number of LTPAs and social contact frequency were more likely to be in the trajectory of early disability with maintained function. Older adults classified in the trajectory of health with fast progressive disability were found to be older, female, with more comorbidity than those in the trajectory of health with maintained function, and had more LTPAs and better social contact than those in the trajectory of early disability with maintained function. Comparing to older adults in the trajectories of health with maintained function and early disability with maintained function, older adults who were in the trajectory of health with fast progressive disability were less educational level when other covariates were controlled. Conclusion: LCGM is a useful approach to identify heterogenetic properties of functional change over time. Older adults with different characters might develop distinct disability trajectory in their late life. Higher education levels might play a substantial role in preventing older adults from rapid physical function deterioration in terms of ADLs and IADLs. Social contact and LTPAs might be beneficial for preventing early disability.