Disability trajectories in activities of daily living of elderly Chinese before death
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Disability trajectories in activities of daily living of elderly Chinese before death Wenjuan Zhang1 · Marcus W. Feldman2 Received: 11 May 2020 / Accepted: 12 August 2020 © The Author(s) 2020
Abstract This study aims to analyze the changes in activities of daily living (ADL) of the Chinese elderly before death, and to explore the heterogeneity in this process. Using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we quantify disability trajectories of ADL using a group-based trajectory model and find that there are three types of disability trajectory for ADL. The elderly who differ by socioeconomic status, childhood experiences, health behaviors, ages and birth cohorts show significant differences in their disability trajectories. Long duration of disability is found to be more prevalent in older females and people with high socioeconomic status. Good and stable status of ADL is more common among males and people of low socioeconomic status, while the elderly in an early cohort who died at older ages were more likely to have experienced a long duration of disability. Selective and protective effects contribute to the observed differences in trajectories. Keywords ADL · Disability trajectory · Heterogeneity · Chinese elderly
1 Introduction Over the last 2 decades, China has experienced accelerated population ageing and the size of the disabled older population has increased, reaching 10.84 million in 2010, which is 6.25% of the total population of older people aged 60 and above (China Research Center on Aging 2012). Functional limitation and disability of older people (meaning they need assistance to carry out basic routine activities for * Wenjuan Zhang [email protected] Marcus W. Feldman [email protected] 1
Institute of Gerontology, School of Sociology and Population Studies, Renmin University of China, 59 Zhongguancun Ave, Haidian District, Beijing 100874, China
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Morrison Institute for Population and Resource Studies, Stanford University, Stanford, CA 94305, USA
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survival) is a crucial consideration in planning the population’s need for long-term care. Assessing the risk of functional limitation and estimating the survival duration with disability is key to estimating the burden of long-term care. However, difficulties still exist in estimating the functional capacity of Chinese older people and predicting their disability prevalence in the future (Zeng et al. 2012). Some researchers argue that the survival time with disability during later life is affected by the demographic transition (Robine and Michel 2004). At the individual level, significant heterogeneity exists in the process of older people becoming disabled (Evert et al. 2003). Instability in the decline of functional capacity also poses a challenge to prediction of the burden of long-term care and increases the difficulty of identifying those in urgent need of care. In previous research, many indicators have been used to evaluate functional capacity of older people
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