BMC Public Health · Oct 21, 2026
Multidimensional health latent transitions and their influencing factors among middle-aged and older adults with chronic diseases from the perspective of healthy aging: a longitudinal analysis of CHARLS data
By Liu L, Liu W, Xiang M et al.
Objective: From the perspective of healthy aging, this study aimed to identify latent classes of multidimensional health among middle-aged and older adults with chronic diseases, examine patterns of health status transitions over time, and investigate the factors associated with these transitions, thereby providing a scientific basis for stratified health management, functional maintenance, and the promotion of healthy aging. Methods: Guided by the World Health Organization (WHO) framework for healthy aging and the Integrated Model of Frailty, longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Multidimensional health was assessed across four dimensions: psychological status, cognitive function, social participation, and physical functioning. Latent profile analysis (LPA) was used to identify distinct multidimensional health profiles, and latent transition analysis (LTA) was conducted to examine patterns of health status transitions over time. Multinomial logistic regression analysis was used to identify factors associated with health status transitions. Results: Three latent profiles were identified: the multidimensional health impairment group, the social functioning-limited group, and the multidimensional health well-functioning group. The social functioning-limited group had the highest proportion and the greatest stability over time. The proportion of individuals in the multidimensional health impairment group increased, whereas that of the multidimensional health well-functioning group decreased, indicating an overall trend toward functional deterioration. Health status transitions primarily occurred between adjacent profiles and were observed in multiple directions, while recovery from impaired health status appeared more difficult. Age, sex, educational attainment, place of residence, self-care ability, and multimorbidity were significantly associated with health status transitions. Conclusion: Middle-aged and older adults with chronic diseases exhibit substantial heterogeneity and dynamic transitions in multidimensional health status, with an overall tendency toward functional deterioration and limited reversibility. Stratified and targeted interventions should be implemented according to different health profiles, with strengthened early screening and long-term health management to delay functional decline and effectively promote healthy aging.