Multidimensional dependency subgroups in community-dwelling older adults: A latent class analysis

Multidimensional health heterogeneity of Chinese older adults and its determinants

Background

Nowadays, the "Healthy China" and "Actively Addressing Population Aging" are two important national strategies in China. Promoting high-quality development of demand-driven older adults health services is an important way to achieve these strategies. From the perspective of active ageing, assessing the health status of older adults from multiple dimensions becomes crucial as it helps identify their specific health service needs, intervention measures, and health policies tailored to this population.

Methods

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) wave 4 (2018). A total of 4190 older adults (aged ≥60 years) were included as the analysis sample. Latent class analysis was performed to categorize older adults based on 6 health indicators, including Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), doctor diagnosed chronic diseases, depressive symptoms, cognitive function, and social participation. Multinomial logistic model was used to explore determinants associated with the various patterns of multidimensional health of older adults.

Results

The multidimensional health of older people was classified into three latent classes: Relatively Healthy (Class 1, n = 2806, 66.97%), Highly Depressed and Relatively Health Risk (Class 2, n = 1189, 28.38%), and Functional Impairment (Class 3, n = 195, 4.65%). Gender, age, education, marital status, number of children, alcohol consumption, physical activity, savings, residence, air quality satisfaction, and medical service satisfaction had significant effects on the attribution of all multidimensional health latent classes.

Conclusion

Heterogeneous and multidimensional health classes exist in China's older population, and these classes are influenced by a variety of factors and to varying degrees. Policymakers and healthcare providers can use these evidence to further address the diverse needs of older adults and improve older-care health services, ultimately achieving the goal of Active Ageing and Healthy China.

Latent dependency classes according to the need for help: a population-based analysis for the older population

Background

Older adults living in the community may have daily needs for help to perform different types of activities. In developing countries, older adults face the additional challenge of lacking sufficient economic means to face their increasing needs with ageing, and health and social policies may be under pressure. The aim of this study was to assess dependency in the older population from a developing country using a latent class approach to identify heterogeneity in the type of activities in which dependent older adults require help.

Methods

In this cross-sectional evaluation of dependency, we considered individuals aged 60 years and older from a nationally representative study (N = 5138) in Uruguay. We fitted latent class regressions to analyse dependency, measured by the need for help to perform Activities of Daily Living, adjusted by sociodemographic characteristics.

Results

Four latent classes were identified, 86.4% of the individuals were identified as non-dependent, 7.4% with help requirements to perform instrumental activities while individuals in the other two classes need help to perform all types of activities with different degrees (4.3 and 1.9%). Less educated women are more likely to be in the group with needs in instrumental activities.

Conclusions

The heterogeneous patterns of dependency have to be addressed with different services that meet the specific needs of dependent older adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03307-w.

Dependency Change with Aging and Associated Factors in Uruguay: A Cohort Study

OBJECTIVES

To assess the heterogeneity of transitions toward dependency in older adults and to explore the robustness of results to different operationalizations of dependency.

METHOD

Using data from people aged 60 years and older from a national representative study in Uruguay (Encuesta Longitudinal de Protección Social, N = 5071), we fitted multinomial regressions adjusted by sociodemographic and health characteristics to model transitions into dependency and death. We used a harder operationalization with basic activities of daily living (Katz-dependency) and Comprehensive-dependency with basic, instrumental, and advanced activities.

RESULTS

Increasing age (RRR = 1.08, CI = [1.05; 1.12], p < .001) and having comorbidities (RRR = 2.16, CI = [1.31; 3.57], p = .003) increased the risk of transition from nondependent to dependent using Katz-dependency. Women with at least two chronic conditions have increased risk of Comprehensive-dependency (RRR = 1.79, CI = [1.15; 2.80], p = .010).

DISCUSSION

Inconsistencies in findings emerged when evaluating transitions into dependency with the different measures, which may have social care implications.