Ethnicity and changing functional health in middle and late life: a person-centered approach.

TitleEthnicity and changing functional health in middle and late life: a person-centered approach.
Publication TypeJournal Article
Year of Publication2010
AuthorsLiang, J, Xu, X, Bennett, JM, Ye, W, Quiñones, AR
JournalThe Journals of Gerontology, Series B
ISSN Number1758-5368
KeywordsAfrican Americans, Age Factors, Aged, Disabled Persons, disease progression, Ethnic Groups, European Continental Ancestry Group, Female, Health Status, Health Status Disparities, Health Surveys, Hispanic Americans, Humans, Likelihood Functions, Male, Marital Status, Middle Aged, Time Factors, United States

OBJECTIVES: Following a person-centered approach, this research aims to depict distinct courses of disability and to ascertain how the probabilities of experiencing these trajectories vary across Black, Hispanic, and White middle-aged and older Americans.

METHODS: Data came from the 1995-2006 Health and Retirement Study, which involved a national sample of 18,486 Americans older than 50 years of age. Group-based semiparametric mixture models (Proc Traj) were used for data analysis.

RESULTS: Five trajectories were identified: (a) excellent functional health (61%), (b) good functional health with small increasing disability (25%), (c) accelerated increase in disability (7%), (d) high but stable disability (4%), and (e) persistent severe impairment (3%). However, when time-varying covariates (e.g., martial status and health conditions) were controlled, only 3 trajectories emerged: (a) healthy functioning (53%), moderate functional decrement (40%), and (c) large functional decrement (8%). Black and Hispanic Americans had significantly higher probabilities than White Americans in experiencing poor functional health trajectories, with Blacks at greater risks than Hispanics.

CONCLUSIONS: Parallel to the concepts of successful aging, usual aging, and pathological aging, there exist distinct courses of changing functional health over time. The mechanisms underlying changes in disability may vary between Black and Hispanic Americans.

Endnote Keywords

Minorities/DISABILITY/DISABILITY/functional Assessment/health outcomes

Endnote ID


Citation Key7406
PubMed ID20008483
PubMed Central IDPMC2883869
Grant List5P30AG024824 / AG / NIA NIH HHS / United States
UL1RR024986 / RR / NCRR NIH HHS / United States
AG154124 / AG / NIA NIH HHS / United States
AG028116 / AG / NIA NIH HHS / United States
UL1 RR024986 / RR / NCRR NIH HHS / United States