Ye Linglong, Wu Zhengman, Kao Yi-Wei, Zhu Jianping, Chen Mingchih, Shia Ben-Chang, Qin Lei
School of Public Affairs, Xiamen University, Xiamen, China.
Department of Applied Statistics and Information Science, Ming Chuan University, Taoyuan, Taiwan.
Front Med (Lausanne). 2025 Jul 25;12:1563419. doi: 10.3389/fmed.2025.1563419. eCollection 2025.
Previous health transition patterns studies only focused on biological and psychological dimensions, and overlooked social dimension. By combining biological, psychological, and social health dimensions, this study aimed to examine heterogeneous transition patterns and assessed their determinants among Chinese middle-aged and older adults.
Four waves of longitudinal data in 2011-2012, 2013, 2015, and 2018 from the China Health and Retirement Longitudinal Study was adopted. A total of 6,161 adults aged ≥45 years with no missing data on three dimensions were included. The repeated-measures latent class analysis as a person-centered approach was used to estimate transition patterns, followed by multinomial logistic regression to assess determinants.
This study highlighted five health transition groups, including "social participation slightly improving followed by deterioration" (SP-ID, 23.62%), "cognitive status deteriorating gradually and lacking social participation" (CS-DG&L-SP, 17.97%), "ADLs deteriorating followed by a slight improvement and lacking social participation" (ADLs-DI&L-SP, 9.14%), "died in the follow-up period" (DIFP, 11.65%), and "sustainedly healthy" (SH, 37.62%). Using the SH group as the reference group, sex, education, job, type of residence, and region have different impact on different patterns. Men were more likely to be in the SP-ID and DIFP groups, while women were more likely to be in the CS-DG&L-SP and ADLs-DI&L-SP groups. Being not in marriage was related to the SP-ID, CS-DG&L-SP, and DIFP groups. Those living in the central region and those having smoking and drinking habits less tended to fall into the SP-ID group. The retired, non-smokers, and drinkers even less tended to be in the CS-DG&L-SP group. Those living in the eastern region, those drinking alcohol appropriately, and those with higher income less tended to be in the ADLs-DI&L-SP group. Being uninsured by public insurance and having lower income were associated with the DIFP group.
Integrating the social dimension with physical and psychological dimensions enhanced our understanding of the heterogeneous health transition patterns of middle-aged and older people. These findings provide valuable evidence for promoting healthy aging targets for different groups of the aging population.
以往的健康转变模式研究仅关注生物和心理维度，而忽视了社会维度。本研究通过整合生物、心理和社会健康维度，旨在探讨中国中老年人异质性的转变模式，并评估其决定因素。
采用来自中国健康与养老追踪调查（China Health and Retirement Longitudinal Study）2011 - 2012年、2013年、2015年和2018年的四轮纵向数据。纳入了6161名年龄≥45岁且在三个维度上无缺失数据的成年人。采用重复测量潜在类别分析这种以个体为中心的方法来估计转变模式，随后进行多项逻辑回归以评估决定因素。
本研究突出了五个健康转变组，包括“社会参与略有改善随后恶化”（SP - ID，23.62%）、“认知状态逐渐恶化且缺乏社会参与”（CS - DG&L - SP，17.97%）、“日常生活活动能力恶化随后略有改善且缺乏社会参与”（ADLs - DI&L - SP，9.14%）、“在随访期内死亡”（DIFP，11.65%）以及“持续健康”（SH，37.62%）。以SH组作为参照组，性别、教育程度、职业、居住类型和地区对不同模式有不同影响。男性更有可能处于SP - ID组和DIFP组，而女性更有可能处于CS - DG&L - SP组和ADLs - DI&L - SP组。未婚与SP - ID组、CS - DG&L - SP组和DIFP组相关。居住在中部地区以及吸烟和饮酒习惯较少的人更倾向于归入SP - ID组。退休人员、不吸烟者和饮酒者更不太可能处于CS - DG&L - SP组。居住在东部地区、适度饮酒者以及收入较高者更不太可能处于ADLs - DI&L - SP组。未参加公共保险且收入较低与DIFP组相关。
将社会维度与身体和心理维度相结合，增强了我们对中老年人异质性健康转变模式的理解。这些发现为促进不同老年人群体的健康老龄化目标提供了有价值的证据。
