Trajectories of Functional Decline in Older Adults: A Latent Class Growth Curve Analysis.
Thomas Dombrowsky
PMID 37288523WHAT IT FOUND
Most older adults stay independent until age 85, but 10% decline rapidly from age 65 and 11% start with high disability.
Comorbidities drive decline more than race or sex. Identify these groups early to target care.
Key findings
01Three distinct trajectories emerged: Late Decline (78.65%), Rapid Decline (10.52%), and High Baseline (10.83%).
02Comorbidities and age had the largest influence on functional status, overriding effects of gender and race in the model.
03The Rapid Decline group started with low disability but declined almost immediately, while the High Baseline group started with high disability and plateaued after age 85.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
Attrition due to death or non-response may bias results, as non-respondents may differ from respondents. Self-report data may overestimate functional ability, especially in nursing home residents or those with cognitive impairment. The Rapid Decline class had lower statistical confidence in classification (posterior probability 0.786). Educational and socioeconomic variables were not included, which are known factors in health outcomes. The study used age as the time variable, which may not capture generational cohort differences.
Declared interests
The author declared no potential conflicts of interest and received no financial support for the research.
The easy way to misread this
Do not assume all older adults follow the same decline pattern. The majority decline late, but a significant minority decline rapidly from age 65. Ignoring comorbidities and focusing only on age misses the strongest predictor of trajectory.