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3-D health trajectories and related childhood predictors among older adults in China.

ABSTRACT: This study aimed to identify the multi-trajectories of 3-D health of older adults in China and to explore whether the childhood predictors are associated with 3-D health trajectory. Data came from five waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). A multi-trajectory modeling approach was carried out to jointly estimate the trajectories of 3-D health. A multinomial regression model was used to investigate the relationships between childhood predictors and the joint trajectories. We identified three typical joint 3-D health trajectories. Female, childhood health, maternal and paternal educations, childhood friendships, family and neighborhood predictors could all affect 3-D health trajectories of older adults directly or indirectly through adult variables. The 3-D health trajectories showed increasing trends, thus the government should perform more interventions toward the childhood predictors for better health of older adults.

SUBMITTER: Pan C

PROVIDER: S-EPMC8110566 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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3-D health trajectories and related childhood predictors among older adults in China.

Pan Chaoping C Wang Cen C Shrestha Bhawana B Wang Peigang P

Scientific reports 20210510 1

This study aimed to identify the multi-trajectories of 3-D health of older adults in China and to explore whether the childhood predictors are associated with 3-D health trajectory. Data came from five waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). A multi-trajectory modeling approach was carried out to jointly estimate the trajectories of 3-D health. A multinomial regression model was used to investigate the relationships between childhood predictors and the ...[more]

PMID: 33972630

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Project description:Stigma and discrimination toward individuals experiencing homelessness and mental disorders remain pervasive across societies. However, there are few longitudinal studies of stigma and discrimination among homeless adults with mental illness. This study aimed to identify the two-year group trajectories of stigma and discrimination and examine the predictive role of mental health characteristics among 414 homeless adults with mental illness participating in the extended follow-up phase of the Toronto At Home/Chez Soi (AH/CS) randomized trial site. Mental health-related perceived stigma and discrimination were measured at baseline, one, and two years using validated scales. Group-based-trajectory modelling was used to identify stigma and discrimination group trajectory memberships and the effect of the Housing First treatment (rent supplements and mental health support services) vs treatment as usual on these trajectories. The associations between mental health-related characteristics and trajectory group memberships were also assessed using multinomial logistic regression. Over two-years, three group trajectories of stigma and discrimination were identified. For discrimination, participants followed a low, moderate, or increasingly high discrimination group trajectory, while for stigma, participants followed a low, moderate or high stigma group trajectory. The Housing First treatment had no significant effect on discrimination or stigma trajectories groups. For the discrimination trajectories, major depressive episode, mood disorder with psychotic features, alcohol abuse, suicidality, severity of mental health symptoms, and substance use severity in the previous year were predictors of moderate and increasingly high discrimination trajectories. History of discrimination within healthcare setting was also positively associated with following a moderate or high discrimination trajectory. For the stigma trajectories, substance dependence, high mental health symptoms severity, substance use severity, and discrimination experiences within healthcare settings were the main predictors for the moderate trajectory group; while substance dependence, suicidality, mental health symptom severity, substance use severity and discrimination experiences within health care setting were also positive predictors for the high stigma trajectory group. Ethno-racial status modified the association between having a major depression episode, alcohol dependence, and the likelihood of being a member of the high stigma trajectory group. This study showed that adults experiencing mental illness and homelessness followed distinct stigma and discrimination group trajectories based on their mental health-problems. There is an urgent need to increase focus on strategies and policies to reduce stigma and discrimination in this population.

Project description:BackgroundAlthough multimorbidity is a risk factor for disability, the relationship between the accumulative patterns of multimorbidity and disability remains poorly understood. The objective of this study was to identify the latent groups of multimorbidity trajectories among mid to older age adults and to examine their associations with incident disability.MethodsWe included 5,548 participants aged ≥ 45 years who participated in the China Health and Retirement Longitudinal Study from 2011 to 2018 and had no multimorbidity (≥ 2 chronic conditions) at baseline. The group-based multi-trajectory modeling was used to identify distinct trajectory groups of multimorbidity based on the latent dimensions underlying 13 chronic conditions. The association between multimorbidity trajectories and incident disability was analyzed using the generalized estimating equation model adjusting for potential confounders.ResultsOf the 5,548 participants included in the current analysis, 2,407 (43.39%) developed multimorbidity during the follow-up. Among participants with new-onset multimorbidity, four trajectory groups were identified according to the combination of newly diagnosed diseases: "Cardiometabolic" (N = 821, 34.11%), "Digestive-arthritic" (N = 753, 31.28%), "Cardiometabolic/Brain" (N = 618, 25.68%), and "Respiratory" (N = 215, 8.93%). Compared to participants who did not develop multimorbidity, the risk of incident disability was most significantly increased in the "Cardiometabolic/Brain" trajectory group (OR = 2.05, 95% CI: 1.55-2.70), followed by the "Cardiometabolic" (OR = 1.96, 95% CI: 1.52 -2.53) and "Digestive-arthritic" (OR = 1.70, 95% CI: 1.31-2.20) trajectory groups.ConclusionsThe growing burden of multimorbidity, especially the comorbid of cardiometabolic and brain diseases, may be associated with a significantly increased risk of disability for mid to older age adults. These findings improve our understanding of multimorbidity patterns that affect the independence of living and inform the development of strategies for the primary prevention of disability.

Dataset Information

3-D health trajectories and related childhood predictors among older adults in China.

Publications

3-D health trajectories and related childhood predictors among older adults in China.

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