Research Square · Nov 20, 2020
Progression of Physical Function Decline and Gender Difference Among the Elderly in China: A Multiple-Group Latent Transition Analysis
By Fang S
Abstract Background: Previous research has shown the physiological basis and empirical evidence for judging representative functional statuses and the functional decline pattern characterized by the specific combination and coevolution of muti-limitations among the elderly. However, as for health measures, under the conventional variable-centered view, studies mostly outlined physical function conditions by quantized severity levels rather than the qualitative profile and possessed the status change just uptrend or downside. This paper's central issue is to identify the constructed latent status of physical function among the Chinese elderly, explore the law of the coexistence and progress of functional limitations, also refine the comprehension of gender inequality with age. Methods: We selected 1578 valid elderly samples who participated in the Chinese Longitudinal Healthy Longevity Survey in 2002, 2008, and 2014, and undertook latent transition analysis to construct the latent status, conduct the membership change overtimes, and examine gender disparity by introducing the multiple-grouplatent model. Results: Chinese elders could be divided into five typical physical functional latent statues.Upper extremity mobility was a distinguishing factor with unimanual dexterity or grip strength. The functional decline started with highly strength-required actions, then, the risk of mobility dysfunction and unimanual indexterity released predominantly, companied by visual and hearing problems. Upper limb disorders rarely occurred alone. The gender differences in distribution and transition of functional status were both distinguishable(ΔG2=74.59,df=4,p<0.000;ΔG2=110.86,df=40, p<0.000). Male elderly preferred maintaining extreme states with a lower risk of deterioration and a higher chance of recovery; females tended toward an unhealthier state and sank into the middle state. Whether gender inequality within physical health expands or shrinks with aging was related closely to the initial status. Conclusion: This study bridges the gap between individualized studies and health measures by typology reference, differentiating the key functional stage and persons at risk. Medical treatments could prioritize the upper limb mobility recure and the strength enhance. Health equity promotion should consider gender typing and original status. Further, individual behaviors under diverse health types would be compared to demonstrate the heterogeneity in real needs and formulate targeted health interventions.