Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
Exp Aging Res. 2023 May-Jun;49(3):289-305. doi: 10.1080/0361073X.2022.2095606. Epub 2022 Jul 3.
Dynamic processes unfolding over later adulthood are of prime interest to gerontological researchers. Time-varying effect modeling (TVEM) accommodates dynamic change trajectories, but its use in gerontological research is limited. We introduce and demonstrate TVEM with an empirical example based on the National Health and Aging Trends Study (NHATS).
We examined (a) age-varying prevalence of past month elevated symptoms of depression and anxiety and (b) age-varying associations between older adults' elevated symptoms of depression and anxiety and needing help with basic activities of daily living and educational attainment.
The proportion of participants reporting elevated symptoms of depression and anxiety in the past month increased gradually from 23-29% across the ages 70-92. Individuals needing help with ADLs had higher odds of reporting elevated symptoms of depression and anxiety, however the association was strongest for those in their 60s versus 80s. Across all ages, adults with lower education levels had higher odds of reporting elevated symptoms of depression and anxiety, an association that also varied by age.
We demonstrated TVEM's value for studying dynamic associations that vary across chronological age. With the recent availability of free, user-friendly software for implementing TVEM, gerontological researchers have a new tool for exploring complex change processes that characterize older adults' development.
晚年动态过程是老年学研究人员关注的焦点。时变效应建模(TVEM)可以适应动态变化轨迹,但在老年学研究中的应用有限。我们将通过基于国家健康与老龄化趋势研究(NHATS)的实证示例介绍并演示 TVEM。
我们考察了(a)过去一个月中,抑郁和焦虑症状加重的老年人比例随年龄的变化;以及(b)老年人抑郁和焦虑症状加重与日常生活活动(ADL)需要帮助和教育程度之间的时变关联。
报告过去一个月中抑郁和焦虑症状加重的参与者比例从 70-92 岁之间逐渐增加,比例为 23-29%。需要 ADL 帮助的个体报告抑郁和焦虑症状加重的几率更高,但这种关联在 60 多岁的个体中最强,而在 80 多岁的个体中较弱。在所有年龄段中,受教育程度较低的成年人报告抑郁和焦虑症状加重的几率更高,这种关联也因年龄而异。
我们展示了 TVEM 用于研究随年龄变化的动态关联的价值。随着最近免费、用户友好的 TVEM 软件的出现,老年学研究人员有了一个新工具来探索描述老年人发展的复杂变化过程。