Latent transition analysis to explore patterns of physical functional decline among older adults in China: A national 6-year longitudinal study

Fang, Shuai; Liang, Yan

doi:10.1016/j.archger.2023.105223

Archives of Gerontology and Geriatrics

2024

DOI: 10.1016/j.archger.2023.105223

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Latent transition analysis to explore patterns of physical functional decline among older adults in China: A national 6-year longitudinal study

Shuai Fang,

Yan Liang

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2024

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Cited by 2 publications

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Patterns of Comorbidity, Disability, and Home Health Care Service for Older Adults With Physical Disability: A Latent Class Analysis and Visualized Illustration

Yi,

Li,

Liang

et al. 2024

Nursing & Health Sciences

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Understanding the relationships between comorbidity, disability, and home health‐care services aids in user‐centered care design. This study identifies patterns of these factors among older adults with physical disability living at home and explores their associations. This cross‐sectional study included community‐dwelling older adults assessed for Long‐term Care Insurance from September 1 to December 31, 2018, in Yiwu, Zhejiang, China. We analyzed deidentified data on sociodemographics, physical disability, chronic conditions, and care plans for 1882 participants using latent class analysis and multinomial logistic regression. Five comorbidity patterns (other sporadic diseases, cancer comorbidity, other sporadic comorbidities, coronary atherosclerotic heart disease, and fracture) and four home health‐care service patterns (assistance & facilitation of elimination, bedridden assistance & stoma care, bedside assistance & stoma care, and assistance & tube feeding) were identified. Four disability patterns emerged (bedridden without incontinence, bedridden & with upper limb mobility, off‐bed & ADLs limited, and bedridden with incontinence). Complex associations between these patterns were observed. The study highlights the heterogeneity and complexity of the above patterns, emphasizing the importance of person‐centered home health‐care services and technology‐supported care strategies.

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Patterns of Comorbidity, Disability, and Home Health Care Service for Older Adults With Physical Disability: A Latent Class Analysis and Visualized Illustration

Yi,

Li,

Liang

et al. 2024

Nursing & Health Sciences

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Typologies of dependency, household characteristics, and disparity in formal and informal care use: analysis of community-dwelling long-term care insurance claimants in an urban municipality of China

Fang,

Liang,

Liang

2023

Int J Equity Health

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Background A comprehensive understanding of subgroups of community-dwelling older adults and their long-term care (LTC) utilization can help to promote equality in the long-term services and support system. Dependency and household characteristics were found to affect the LTC utilization of homebound older adults. However, few studies considered the typologies of dependency of older populations according to co-occurring limitations, and little is known about differences in LTC use among elderly of typologies of dependency under distinct household conditions. Methods We aimed to identify typologies of dependency of older adults living at home and explore the disparities in formal care and informal care use among typologies of dependency by income and living situation. In this cross-sectional study, we used the public long-term care insurance (LTCI) database of Yiwu, Zhejiang Province, China, and included 1675 individuals aged ≥ 60 years living at home. Cluster analysis was conducted to determine typologies of dependency among older adults. A two-step multilevel analysis was used to examine disparities in formal and informal care use related to household income and living status among typologies of dependency. Results Seven dependency clusters were identified. Pro-wealthy inequalities in both formal and informal care use were found in the least dependent cluster and the limited-locomotion cluster. Pro-poor inequalities in formal care use were found in the fully dependent cluster without impaired vision and the cluster with intact continence and vision. Living with family members was positively associated with receiving formal care for the fully dependent cluster. Older adults in most clusters were more likely to use informal care when living with family members, except for the least dependent cluster and the limited-locomotion cluster. Conclusions Our findings suggest that household inequalities in LTC use varied among typologies of dependency of older adults, which may provide insights for researchers and policymakers to develop tailored LTC and targeted LTCI programs for older adults living at home and their family caregivers, considering both typologies of dependency and household characteristics.

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Latent transition analysis to explore patterns of physical functional decline among older adults in China: A national 6-year longitudinal study

Cited by 2 publications

References 31 publications

Patterns of Comorbidity, Disability, and Home Health Care Service for Older Adults With Physical Disability: A Latent Class Analysis and Visualized Illustration

Patterns of Comorbidity, Disability, and Home Health Care Service for Older Adults With Physical Disability: A Latent Class Analysis and Visualized Illustration

Typologies of dependency, household characteristics, and disparity in formal and informal care use: analysis of community-dwelling long-term care insurance claimants in an urban municipality of China

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