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Deeg DJH, Hoogendijk EO, van Schoor NM, Schaap LA, Lima Passos V. Joint Trajectories of Performance-Based and Self-Reported Physical Functioning in Older Adults: A 20-Year Longitudinal Study in the Netherlands. J Aging Health 2024:8982643241273298. [PMID: 39167684 DOI: 10.1177/08982643241273298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
BACKGROUND The well-known disablement process has been conceptualized as a series of transitions between progressive states of functional decline. We studied joint patterns of change within disablement states defined as walking speed, grip strength, and self-reported disability. METHODS 1702 participants aged 65 and over were included from the Longitudinal Aging Study Amsterdam, spanning seven waves over 20 years (1996-2016). Group-based multi-trajectory modeling yielded trajectory clusters (TCs) of different patterns of change, further characterized by baseline sociodemographic characteristics, physical and cognitive health, and survival rate. RESULTS Five TCs were identified, distinguished by increasing baseline age. Walking speed and disability showed generally concomitant trajectories. Women had poorer trajectories in grip strength than men, but not in walking speed and disability. Poor physical health distinguished especially the poorest, and cognitive impairment distinguished especially the one-before-poorest from the better TCs. DISCUSSION The findings suggest that the disablement states are not generally distinct or sequential.
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Affiliation(s)
- Dorly J H Deeg
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute/Ageing and Later Life Program, Amsterdam University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Emiel O Hoogendijk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute/Ageing and Later Life Program, Amsterdam University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute/Ageing and Later Life Program, Amsterdam University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Laura A Schaap
- Faculty of Science, Department of Health Sciences, Amsterdam Public Health Research Institute/Ageing and Later Life program, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Valéria Lima Passos
- Maastricht University, Faculty of Health, Medicine and Life Sciences, Department of Methodology and Statistics, CAPHRI Care and Public Health Research Institute, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons, Dublin, Ireland
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Zang E, Shi Y, Wang X, Wu B, Fried TR. Trajectories of physical functioning among US adults with cognitive impairment. Age Ageing 2022; 51:6615423. [PMID: 35751871 PMCID: PMC9233517 DOI: 10.1093/ageing/afac139] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND physical functioning impairment is common among persons with cognitive impairment, but little is known about physical functioning trajectories across the US population or how trajectories may differ among persons with dementia and mild cognitive impairment (MCI). OBJECTIVE to examine trajectories of physical functioning among persons with MCI and dementia in the USA. DESIGN we used data from the National Health and Aging Trends study (NHATS) 2011-18. Physical functioning was assessed using the NHATS Expanded Short Physical Performance Battery. PARTICIPANTS the 661 individuals with MCI and 980 individuals with dementia were included in this study. METHODS we applied group-based trajectory models to identify latent groups and estimate their trajectories. Multinomial logistic regressions were applied to examine relationships between sociodemographic and health characteristics and trajectory group memberships. RESULTS both MCI- and dementia-specific trajectories differed at baseline levels and declined at varying rates across groups. Approximately, 78.43% of persons with MCI were in trajectories with a moderate rate of decline, with only 9.75% in a trajectory with good physical function and 11.82% with poor physical function without as much change over time. Among persons with dementia, approximately 81.4% experienced moderate or fast declines, and 18.52% with virtually no functional ability remained at this same low level. Worse physical functioning trajectories were found among persons who were females, Blacks, with at least four comorbidities, and among persons who had a low socioeconomic status. CONCLUSIONS persons with both dementia and MCI experienced steady declines in physical functioning. Socioeconomically disadvantaged groups have worse physical functioning trajectories.
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Affiliation(s)
- Emma Zang
- Address correspondence to: Emma Zang, Departments of Sociology and Biostatistics, Yale University, New Haven, CT 06511, USA. Tel: +1 (919) 536-9621.
| | - Yu Shi
- Department of Biostatistics, Yale University, New Haven, CT 06520, USA
| | - Xueqing Wang
- Office of Population Research, Princeton University, Princeton, NJ 08540, USA
- School of Public and International Affairs, Princeton University, Princeton, NJ 08540, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY 10010, USA
| | - Terri R Fried
- Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516, USA
- Department of Medicine, Yale School of Medicine, New Haven, CT 06520, USA
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Ghisla V, Chocano-Bedoya PO, Orav EJ, Abderhalden LA, Sadlon A, Egli A, Krützfeldt J, Kanis JA, Bischoff-Ferrari HA. Prospective Study of Ageing Trajectories in the European DO-HEALTH Study. Gerontology 2022; 69:57-64. [PMID: 35443250 PMCID: PMC9148895 DOI: 10.1159/000523923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 02/10/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Ageing trajectories range from delayed ageing with extended health to accelerated ageing, with an increased risk of frailty. We evaluated the prevalence and prospective change between health states among community-dwelling European older adults. METHODS This prospective study is a secondary analysis of DO-HEALTH, a randomized trial that included adults aged 70 years and older across 5 European countries. Healthy agers (HA) fulfilled the Nurses' Health Study healthy ageing criteria and accelerated agers were non-HA being at least pre-frail according to the Fried frailty criteria. We assessed the proportion of participants changing between health states over 4 assessments and evaluated the odds of changing to a more favourable category. To increase reliability and avoid regression to the mean, we averaged the first 2 years and compared them to the average of the last 2 years. RESULTS Of 2,157 participants, 12.4% were excluded for meeting both healthy ageing and pre-frailty criteria simultaneously. Among the remaining 1,889 participants (mean age 75.1 years, 60.9% female), 23.1% were initially HA, 44.4% were non-HA but not pre-frail, and 32.6% were pre-frail or frail. Subsequently, 65.3% remained in the same health state, 12.0% improved to a healthier state, and 22.8% progressed to a less advantageous state. After adjusting for sex, study centre, treatment, and body mass index, each year of age was associated with 6% lower odds of improving health states. Women had 35% higher odds than men of following a disadvantageous trajectory. CONCLUSION We observed dynamic trajectories of ageing where transitioning to a healthier state became less likely with advancing age and among women.
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Affiliation(s)
- Virginia Ghisla
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland,University Clinic for Aging Medicine, Zurich City Hospital-Waid, Zurich, Switzerland
| | - Patricia O. Chocano-Bedoya
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland,Population Health Lab, University of Fribourg, Fribourg, Switzerland
| | - Endel John Orav
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lauren A. Abderhalden
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
| | - Angélique Sadlon
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Andreas Egli
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
| | - Jan Krützfeldt
- Department of Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - John A. Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia,Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - Heike A. Bischoff-Ferrari
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland,University Clinic for Aging Medicine, Zurich City Hospital-Waid, Zurich, Switzerland,Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland,*Heike A. Bischoff-Ferrari,
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Pruchno R, Wilson-Genderson M, Heid AR, Cartwright FP. Effects of peri-traumatic stress experienced during Hurricane Sandy on functional limitation trajectories for older men and women. Soc Sci Med 2021; 281:114097. [PMID: 34120083 PMCID: PMC8276253 DOI: 10.1016/j.socscimed.2021.114097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/13/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND METHODS Although the short-term effects of disasters on the physical health of mid-life and older people have been documented, little is understood about the long-term effects that disasters have on the physical health of these people. Based on the environmental docility hypothesis and research regarding gender effects on functional limitations and disaster, our analyses examined the effects of peri-traumatic stress experienced during Hurricane Sandy using longitudinal data from 5688 people aged 50 and older collected over six waves (2006-2019). RESULTS We found that functional limitations follow three trajectories, with people in each group having a significant linear increase over time and all but the highest functioning people also having a significant quadratic effect, indicating that the linear increase peaked post-Hurricane and then slowed in later waves. CONCLUSION Consistent with the environmental docility hypothesis, peri-traumatic stress had its greatest impact on people with more functional limitations before the hurricane. Men experiencing peri-traumatic stress during Hurricane Sandy were more likely to experience an increase in functional limitations than women. These findings, which identify people most likely to experience long-term health effects following a disaster, can be used to inform health policies before, during, and after disaster strikes.
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Affiliation(s)
- Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
| | | | | | - Francine P Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
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Qiu L, Chen Q, Gao T. The Effects of Urban Natural Environments on Preference and Self-Reported Psychological Restoration of the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020509. [PMID: 33435508 PMCID: PMC7826542 DOI: 10.3390/ijerph18020509] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/31/2020] [Accepted: 01/06/2021] [Indexed: 12/28/2022]
Abstract
The world is facing the challenge of aging populations. Urban natural environments, including green spaces and blue spaces, have been demonstrated to have great benefits to the mental restoration of the elderly. However, the study of the specific characteristics of urban environments that are popular and the most restorative for the elderly is still lacking. Photo elicitation as visual stimuli was utilized to explore the differences in preference and psychological restoration of the elderly through the perception of the eight perceived sensory dimensions (PSDs) in different types of urban environments. The results showed that: (1) The respondents had different perceptions of the eight PSDs in the different urban natural environments. Blue space and partly-closed green space were more preferred by the elderly, and also had more psychological restorative effects on the elderly. (2) There was no significant correlation between the number of highly perceived PSDs and preference, as well as between the number of highly perceived PSDs and psychological restoration. However, there was a significant correlation between preference and psychological restoration. (3) Partly-closed green space with more Serene and Refuge qualities, and blue space with more Serene, Refuge and Prospect properties were optimal characteristics for psychological restoration of the elderly. In addition, open green space with more Prospect, Serene and Social qualities, and closed green space with more Space, Refuge and less Nature properties could also increase psychological restoration of older adults. These findings can provide useful guidelines for restorative environmental design for the elderly in the future.
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Toyama M, Fuller HR, Owino J. Longitudinal Implications of Social Integration for Age and Gender Differences in Late-Life Physical Functioning. Int J Aging Hum Dev 2020; 94:169-192. [PMID: 33307713 DOI: 10.1177/0091415020980755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social integration has documented benefits for late-life health; yet, little is known about its impacts on trajectories of physical functioning. This study examines age and gender differences in the longitudinal associations between social integration and activities of daily living (ADLs) using a hierarchical linear model with three waves of survey data collected over 4 years from the Social Integration and Aging Study (N = 400; baseline mean age = 80.3). Findings indicated some interaction effects of age, gender, and/or social integration on ADL trajectories. Among those of more advanced age, women showed greater increases in ADL limitations than men, and individuals with lower social integration experienced greater increases in ADL limitations than those with higher social integration. Neither of these patterns were found among younger older adults. This study highlights the benefits of longitudinal research on social integration and the need to explore practical interventions for promoting social integration particularly among the oldest older adults.
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Affiliation(s)
- Masahiro Toyama
- 3323 Division of Natural Sciences and Mathematics, University of the Ozarks, Clarksville, AR, USA
| | - Heather R Fuller
- 174543 Department of Human Development and Family Science, North Dakota State University, Fargo, ND, USA
| | - Jonix Owino
- 174543 Department of Human Development and Family Science, North Dakota State University, Fargo, ND, USA
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Pauelsen M, Jafari H, Strandkvist V, Nyberg L, Gustafsson T, Vikman I, Röijezon U. Frequency domain shows: Fall-related concerns and sensorimotor decline explain inability to adjust postural control strategy in older adults. PLoS One 2020; 15:e0242608. [PMID: 33216812 PMCID: PMC7678972 DOI: 10.1371/journal.pone.0242608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/05/2020] [Indexed: 11/19/2022] Open
Abstract
Human postural control is a complex system and changes as we age. Frequency based analyses have been argued to be useful to identify altered postural control strategies in balance tasks. The aim of this study was to explore the frequency domain of the quiet stance centre of pressure of older adults with various degrees of fall-related concerns and sensorimotor functioning. We included 45 community dwelling older adults and used a force plate to register 30 seconds of quiet stance with eyes open and closed respectively. We also measured sensory and motor functions, as well as fall-related concerns and morale. We analysed the centre of pressure power spectrum density and extracted the frequency of 4 of its features for each participant. Orthogonal projection of latent structures-discriminant analysis revealed two groups for each quiet stance trial. Group 1 of each trial showed less sensory and motor decline, low/no fall-related concerns and higher frequencies. Group 2 showed more decline, higher fall-related concerns and lower frequencies. During the closed eyes trial, group 1 and group 2 shifted their features to higher frequencies, but only group 1 did so in any significant way. Higher fall-related concerns, sensory and motor decline, and explorative balancing strategies are highly correlated. The control system of individuals experiencing this seems to be highly dependent on vision. Higher fall-related concerns, and sensory and motor decline are also correlated with the inability to adjust to faster, more reactive balancing strategies, when vision is not available.
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Affiliation(s)
- Mascha Pauelsen
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
- * E-mail:
| | - Hedyeh Jafari
- Department of Computer Science, Electrical and Space Engineering Luleå University of Technology, Luleå, Sweden
| | - Viktor Strandkvist
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Lars Nyberg
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Thomas Gustafsson
- Department of Computer Science, Electrical and Space Engineering Luleå University of Technology, Luleå, Sweden
| | - Irene Vikman
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Ulrik Röijezon
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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de Keijzer C, Tonne C, Sabia S, Basagaña X, Valentín A, Singh-Manoux A, Antó JM, Alonso J, Nieuwenhuijsen MJ, Sunyer J, Dadvand P. Green and blue spaces and physical functioning in older adults: Longitudinal analyses of the Whitehall II study. ENVIRONMENT INTERNATIONAL 2019; 122:346-356. [PMID: 30503316 PMCID: PMC6571017 DOI: 10.1016/j.envint.2018.11.046] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/19/2018] [Accepted: 11/19/2018] [Indexed: 05/21/2023]
Abstract
There is increasing evidence of the health benefits of exposure to natural environments, including green and blue spaces. The association with physical functioning and its decline at older age remains to be explored. The aim of the present study was to investigate the longitudinal association between the natural environment and the decline in physical functioning in older adults. We based our analyses on three follow-ups (2002-2013) of the Whitehall II study, including 5759 participants (aged 50 to 74 years at baseline) in the UK. Exposure to natural environments was assessed at each follow-up as (1) residential surrounding greenness across buffers of 500 and 1000 m around the participants' address using satellite-based indices of greenness (Enhanced Vegetation Index (EVI) and Normalized Difference Vegetation Index (NDVI)) and (2) the distance from home to the nearest natural environment, separately for green and blue spaces, using a land cover map. Physical functioning was characterized by walking speed, measured three times, and grip strength, measured twice. Linear mixed effects models were used to quantify the impact of green and blue space on physical functioning trajectories, controlled for relevant covariates. We found higher residential surrounding greenness (EVI and NDVI) to be associated with slower 10-year decline in walking speed. Furthermore, proximity to natural environments (green and blue spaces combined) was associated with slower decline in walking speed and grip strength. We observed stronger associations between distance to natural environments and decline in physical functioning in areas with higher compared to lower area-level deprivation. However, no association was observed with distance to green or blue spaces separately. The associations with decline in physical functioning were partially mediated by social functioning and mental health. Our results suggest that higher residential surrounding greenness and living closer to natural environments contribute to better physical functioning at older ages.
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Affiliation(s)
- Carmen de Keijzer
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cathryn Tonne
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Séverine Sabia
- INSERM, U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France; Department of Epidemiology and Public Health, University College of London, London, UK
| | - Xavier Basagaña
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antònia Valentín
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Archana Singh-Manoux
- INSERM, U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France; Department of Epidemiology and Public Health, University College of London, London, UK
| | - Josep Maria Antó
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Alonso
- Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IMIM-Parc Salut Mar, Barcelona, Catalonia, Spain
| | - Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Sunyer
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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MacNeil Vroomen JL, Han L, Monin JK, Lipska KJ, Allore HG. Diabetes, Heart Disease, and Dementia: National Estimates of Functional Disability Trajectories. J Am Geriatr Soc 2018. [PMID: 29521414 DOI: 10.1111/jgs.15284] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To estimate the associations between diabetes, heart disease, and dementia, which may increase the difficulty of self-care; model functional disability trajectories jointly with attrition (death or dropout) over 5 years. DESIGN Population-based complex survey design. SETTING National Health and Aging Trends Study. PARTICIPANTS Community-dwelling Medicare beneficiaries aged 65 and older (N=7,609). MEASUREMENTS National estimates were generated using sampling weights. Sociodemographic characteristics, self-reported physician-diagnosed chronic conditions, six activities of daily living (ADL), and cognitive status were ascertained in annual in-person interviews. A joint model using group-based trajectory modeling was used to estimate the number of ADL disabilities and attrition probability. Multinomial logistic regression with survey weights was used to estimate the association between diabetes, heart disease, and dementia and resultant trajectories of disability, with the least disabled trajectory used as a reference. RESULTS Three functional disability trajectories were identified: 26.9 million (76.3%) individuals with no disability and a constant study attrition of 14.3%, 4.9 million (13.9%) with mild and increasing disability and 12% attrition in 2012 and 27.2% in 2015, and 3.4 million (9.7%) with severe and increasing disability and 25.4% attrition in 2012 and 35% in 2015. Persons with possible dementia, possible dementia and diabetes, or possible dementia with diabetes and heart disease had significantly greater odds of being on the mild disability trajectory than those with no disability. Persons with probable dementia, representing more than 1.5 million persons, regardless of concurrent conditions, had significantly greater odds of being on the severe disability trajectory than on the no disability trajectory. CONCLUSIONS Methods that generate national estimates and account for attrition and for multiple chronic conditions and cognitive status may be useful for health policy-makers to make decisions on care provisions and services.
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Affiliation(s)
- Janet L MacNeil Vroomen
- Section of Geriatrics, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut
| | - Ling Han
- Section of Geriatrics, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut
| | - Joan K Monin
- Social and Behavioral Sciences Department, School of Public Health, Yale University, New Haven, Connecticut
| | - Kasia J Lipska
- Section of Endocrinology Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut
| | - Heather G Allore
- Section of Geriatrics, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut.,Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut
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Picavet HSJ, Blokstra A, Spijkerman AMW, Verschuren WMM. Cohort Profile Update: The Doetinchem Cohort Study 1987-2017: lifestyle, health and chronic diseases in a life course and ageing perspective. Int J Epidemiol 2017; 46:1751-1751g. [PMID: 29040549 PMCID: PMC5837330 DOI: 10.1093/ije/dyx103] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/16/2017] [Accepted: 05/22/2017] [Indexed: 12/26/2022] Open
Affiliation(s)
- H S J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
| | - Anneke Blokstra
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
| | - Annemieke MW Spijkerman
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
| | - WM Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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