Objective: This research sought to identify patterns of joint changes in physical, emotional and cognitive functioning among older Americans and examine their association with social stratification.
Methods: We used data from a nationally representative sample of 9,237 Americans age 65 or older from the Health and Retirement Study, who were observed biennially from 1998 to 2010. Joint trajectories of physical, emotional, and cognitive functioning were characterized via a group-based mixture model. We then applied multinomial logistic regression analysis to evaluate their linkages with social stratification.
Results: We identified four distinct patterns of joint changes in physical, emotional and cognitive function over time. Accounting for 30.9%, 23.7%, 24.6%, and 20.8% of the older Americans sampled, these trajectory groups characterize respectively minimal, mild, moderate, and severe levels of impairment and decline. Advanced age, racial/ethnic minority and lower socioeconomic status were associated with a greater likelihood of experiencing more rapid decline or greater impairment.
Conclusions: Distinct patterns of joint trajectories in physical, emotional and cognitive function exist in old age. Such heterogeneity underscores the need for personalized care in and tailored interventions in geriatric medicine, while synchrony in impairment/decline across the three health dimensions calls for comprehensive geriatric care.