Dynamics of functional aging based on latent-class trajectories of activities of daily living

Ling Han, Heather Allore, Terrence Murphy, Thomas Gill, Peter Peduzzi, Haiqun Lin

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Purpose: This study sought to identify and characterize major patterns of functional aging based on activities of daily living (ADL). Methods: We followed 754 community-living adults aged 70 years or older monthly for ADLs, instrumental ADLs, hospitalization and restricted activity over 10 years. A generalized growth mixture model was used to identify traje ctories of ADL disability across seven 18-month intervals. Cumulative burdens of disability and morbidity from different trajectories were examined using a generalized estimating equation Poisson model. Results: Five distinct trajectories emerged. The predominant trajectory maintained ADL independence, with membership probability being 61.6%. The remaining trajectories either stayed at low (1 or 2 ADLs, 13.6%) or high (3 or 4 ADLs, 7.0%) levels of disability or declined gradually toward low (11.2%) or high (6.5%) disability. The independent trajectory was associated with the lowest burdens of disability and morbidity and a decreasing time trend of restricted activity, whereas the high disability trajectory demonstrated opposite trends. About 31% of the cohort remained in the same trajectory throughout the follow-up period. Conclusions: The course of functional aging is heterogeneous and dynamic. Although most older adults maintain functional autonomy, some may experience persistent disability or progress toward severe disability with substantial morbidity.

Original languageEnglish (US)
Pages (from-to)87-92
Number of pages6
JournalAnnals of Epidemiology
Issue number2
StatePublished - Feb 2013

All Science Journal Classification (ASJC) codes

  • Epidemiology


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