Instituto de Sociología & Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.
Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Santiago, Chile.
J Gerontol B Psychol Sci Soc Sci. 2022 Jul 5;77(7):1280-1293. doi: 10.1093/geronb/gbab116.
Despite the enormous advances in the field, most evidence about functional ability trajectories in old age comes from studies conducted in developed and high-income countries. This research aims to build on these previous advances to examine functional ability trajectories in Chile.
Drawing on a robust, publicly available 15-year panel data set (2004-2018), and using sequence analysis, we examine functional ability trajectories types among 4 age groups (people aged 46-50, 51-55, 56-60, and 61-64 at baseline). Then, we analyze trajectories' dynamics looking at intraindividual health-declining and health-recovery transitions between functional ability statuses, within each trajectory type. Finally, we assess how multiple baseline individual characteristics predict the likelihood of following a functional ability trajectory type, using multinomial regression models.
Across all age groups, an important fraction (between 26% and 50%) reports stable healthy trajectories, and between 10% and 20% follow equivocal-declining trajectories (i.e., exhibiting both health-declining and health-recovery intraindividual transitions), suggesting that age might not be the main source of heterogeneity in functional ability trajectories. Overall, women, lower educated people, nonworking individuals, and people with a higher burden of chronic conditions at baseline are more prevalent among health-declining trajectory types; however, these results are not constant across the age groups analyzed.
This nationally focused study reinforces the feasibility and usefulness of an in-depth analysis of functional ability trajectories in old age. The study findings can be crucial to define different prevention strategies according to the functional ability path that an individual might follow, especially in countries like Chile that currently navigate the challenges of population aging.
尽管该领域取得了巨大进展，但大多数关于老年人功能能力轨迹的证据来自于在发达国家和高收入国家进行的研究。本研究旨在借鉴这些先前的进展，研究智利的功能能力轨迹。
利用一个强大的、公开可用的 15 年面板数据集（2004-2018 年），并使用序列分析，我们在 4 个年龄组（基线时年龄为 46-50、51-55、56-60 和 61-64 岁）中检查了功能能力轨迹类型。然后，我们分析了每个轨迹类型内功能能力状态之间个体健康下降和健康恢复的个体内健康转变轨迹的动态。最后，我们使用多项回归模型评估了多个基线个体特征预测遵循功能能力轨迹类型可能性的情况。
在所有年龄组中，相当一部分（26%-50%）报告稳定的健康轨迹，10%-20%的人跟随不确定的下降轨迹（即，表现出健康下降和健康恢复的个体内转变），这表明年龄可能不是功能能力轨迹异质性的主要来源。总体而言，女性、受教育程度较低的人、非就业者以及基线时患有更多慢性疾病的人更常见于健康下降轨迹类型；然而，这些结果在分析的年龄组中并不稳定。
这项以国家为重点的研究加强了深入分析老年人功能能力轨迹的可行性和实用性。研究结果对于根据个人可能遵循的功能能力路径确定不同的预防策略至关重要，特别是在智利等目前正在应对人口老龄化挑战的国家。
