Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-20T04:30:59.692Z Has data issue: false hasContentIssue false

Trajectories of positive aging: observations from the women's health initiative study

Published online by Cambridge University Press:  17 April 2014

Oleg Zaslavsky*
Affiliation:
Faculty of Health Science and Social Welfare, University of Haifa, Haifa, Israel
Barbara B. Cochrane
Affiliation:
School of Nursing, University of Washington, Seattle, Washington, USA Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
Nancy Fugate Woods
Affiliation:
School of Nursing, University of Washington, Seattle, Washington, USA
Andrea Z. LaCroix
Affiliation:
Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
Jingmin Liu
Affiliation:
Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
Jerald R. Herting
Affiliation:
Department of Sociology, University of Washington, Seattle, Washington, USA
Joseph S. Goveas
Affiliation:
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Karen C. Johnson
Affiliation:
Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA
Lewis H. Kuller
Affiliation:
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Lisa W. Martin
Affiliation:
Division of Cardiology, George Washington University, Washington, District of Columbia, USA
Yvonne L. Michael
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
Jennifer G. Robinson
Affiliation:
Departments of Medicine and Epidemiology, University of Iowa, Iowa City, Iowa, USA
Marcia Stefanick
Affiliation:
Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, California, USA
Lesley F. Tinker
Affiliation:
Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
*
Correspondence should be addressed to: Oleg Zaslavsky, PhD, Department of Nursing, Faculty of Health Sciences and Social Welfare, University of Haifa, Haifa 31905Israel. Phone: +972-48288749; Fax: +972-48288017. Email: [email protected].

Abstract

Background:

The purpose of this study was to describe the longitudinal trajectories and bidirectional relationships of the physical-social and emotional functioning (EF) dimensions of positive aging and to identify their baseline characteristics.

Methods:

Women age 65 and older who enrolled in one or more Women's Health Initiative clinical trials (WHI CTs) and who had positive aging indicators measured at baseline and years 1, 3, 6, and 9 were included in these analyses (N = 2281). Analytic strategies included latent class growth modeling to identify longitudinal trajectories and multinomial logistic regression to examine the effects of baseline predictors on these trajectories.

Results:

A five-trajectory model was chosen to best represent the data. For Physical-Social Functioning (PSF), trajectory groups included Low Maintainer (8.3%), Mid-Low Improver (10.4%), Medium Decliner (10.7%), Mid-High Maintainer (31.2%), and High Maintainer (39.4%); for EF, trajectories included Low Maintainer (3%), Mid-Low Improver (9%), Medium Decliner (7.7%), Mid-High Maintainer (22.8%), and High Maintainer (57.5%). Cross-classification of the groups of trajectories demonstrated that the impact of a high and stable EF on PSF might be greater than the reverse. Low depression symptoms, low pain, and high social support were the most consistent predictors of high EF trajectories.

Conclusion:

Aging women are heterogeneous in terms of positive aging indicators for up to 9 years of follow-up. Interventions aimed at promoting sustainable EF might have diffused effects on other domains of healthy aging.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, G. L. et al. (2003). Implementation of the Women's Health Initiative study design. Annals of Epidemiology, 13 (9S), S5S17. doi:10.1016/S1047-2797(03)00043-7.CrossRefGoogle ScholarPubMed
Berkman, L. F. and Syme, S. L. (1979). Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology, 109, 186204.Google Scholar
Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R. and Pamuk, E. (2010) Socioeconomic disparities in health in the United States: what the patterns tell us. American Journal of Public Health, 100 (1S), S186–S196. doi:10.2105/AJPH.2009.166082.Google Scholar
Burnam, M. A., Wells, K. B., Leake, B. and Landsverk, J. (1988). Development of a brief screening instrument for detecting depressive disorders. Medical Care, 26, 775789. doi:10.1097/00005650-198808000-00004.Google Scholar
Depp, C. and Jeste, D. (2006). Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies. American Journal of Geriatric Psychiatry, 14, 620. doi:10.1097/01.JGP.0000192501.03069.bc.Google Scholar
Ferro, M. A., Avison, W. R., Campbell, M. K. and Speechley, K. N. (2011). Prevalence and trajectories of depressive symptoms in mothers of children with newly diagnosed epilepsy. Epilepsia, 52, 326336. doi:10.1111/j.1528-1167.2010.02899.x.CrossRefGoogle ScholarPubMed
Fried, L. P. et al. (2001). Frailty in older adults: evidence for a phenotype. Journal of Gerontology. Series A, Biological Sciences and Medical Sciences, 56, M146–M156. doi:10.1093/gerona/56.3.M146.CrossRefGoogle ScholarPubMed
Gill, T. M., Gahbauer, E. A., Han, L. and Allore, H. G. (2010). Trajectories of disability in the last year of life. New England Journal of Medicine, 362, 11731180. doi:10.1056/NEJMoa0909087.CrossRefGoogle ScholarPubMed
Hays, J. et al. (2003). The Women's Health Initiative recruitment methods and results. Annals of Epidemiology, 13 (9S), S18–S77. doi:10.1016/S1047-2797(03)00042-5.CrossRefGoogle ScholarPubMed
Jones, B. L., Nagin, D. S. and Roeder, K. A. (2001). A SAS procedure based on mixture models for estimating developmental trajectories. Sociological Methods & Research, 29, 374393. doi:10.1177/0049124101029003005.CrossRefGoogle Scholar
Kaplan, M. S., Huguet, N., Orpana, H., Feeny, D., McFarland, B. H. and Ross, N. (2008). Prevalence and factors associated with thriving in older adulthood: a 10-year population-based study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 3A, 10971104. doi:10.1093/gerona/63.10.1097.Google Scholar
Kurland, B. F., Gill, T. M., Patrick, D. L., Larson, E. B. and Phelan, E. A. (2006). Longitudinal change in positive affect in community-dwelling older persons. Journal of the American Geriatrics Society, 54, 18461853. doi:10.1111/j.1532-5415.2006.00970.x.Google Scholar
Lenze, E. J. et al. (2001). The association of late-life depression and anxiety with physical disability: a review of the literature and prospectus for future research. American Journal of Geriatric Psychiatry, 9, 113135. http://dx.doi.org/10.1097/00019442-200105000-00004.Google Scholar
Levine, D. W. et al. (2003). Reliability and validity of the Women's Health Initiative Insomnia Rating Scale. Psychological Assessment, 15, 137148. doi:10.1037/1040-3590.15.2.137.Google Scholar
Matthews, K. A. et al. (1997). Women's health initiative. Why now? What is it? What's new? The American Psychologist, 52, 101116. doi:10.1037/0003-066X.52.2.101.Google Scholar
Mehta, K. M. et al. (2007). Anxiety symptoms and decline in physical function over 5 years in the health, aging and body composition study. Journal of the American Geriatrics Society, 55, 265270. doi:10.1111/j.1532-5415.2007.01041.x.Google Scholar
Minicuci, N., Marzari, C., Maggi, S., Noale, M., Senesi, A. and Grepaldi, G. (2005). Predictors of transitions in vitality: the Italian longitudinal study on aging. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 60, 566573. doi:10.1093/gerona/60.5.566.CrossRefGoogle ScholarPubMed
Nagin, D. S. (2005). Group-Based Modeling of Development. Cambridge, MA: Harvard University Press CrossRefGoogle Scholar
Nagin, D.S. and Odgers, C. L. (2010). Group-based trajectory modeling in clinical research. Annual Review of Clinical Psychology, 6, 109138. doi:10.1146/annurev.clinpsy.121208.131413.Google Scholar
Phelan, E. A., Anderson, L. A., LaCroix, A. Z. and Larson, E. B. (2004). Older adults’ views of “successful aging”—how do they compare with researchers’ definitions? Journal of American Geriatric Society, 52, 211216.CrossRefGoogle ScholarPubMed
Rowe, J. and Kahn, R. (1997). Successful aging. Gerontologist, 37, 433440. doi:10.1093/geront/37.4.433.Google Scholar
Scheier, M. F. and Carver, C. S. (1985). Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychology, 4, 219247. doi:10.1037/0278-6133.4.3.219.Google Scholar
Sherbourne, C. D. and Stewart, A. L. (1991). The MOS social support survey. Social Science & Medicine, 32, 705714. doi:10.1016/0277-9536(91)90150-B.Google Scholar
Strawbridge, W. J., Cohen, R. D., Shema, S. J. and Kaplan, G. A. (1996). Successful aging: predictors and associated activities. American Journal of Epidemiology, 144, 135141. doi:10.1093/oxfordjournals.aje.a008900.Google Scholar
Strawbridge, W., Wallhagen, M. and Cohen, R. (2002). Successful aging and well-being: self-rated compared with Rowe and Kahn. Gerontologist, 42, 727733. doi:10.1093/geront/42.6.727.Google Scholar
Wang, L., van Belle, G., Kukull, W. B. and Larson, E. B. (2002). Predictors of functional change: a longitudinal study of nondemented people aged 65 and older. Journal of American Geriatric Society, 50, 15251534. doi:10.1046/j.1532-5415.2002.50408.x.CrossRefGoogle Scholar
Ware, J. E. Jr. and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): 1. Conceptual framework and item selection. Medical Care, 30, 473483. doi:10.1097/00005650-199206000-00002.Google Scholar
Woods, N. F. et al. (2012). Toward a positive aging phenotype for older women: observations from the women's health initiative. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 67, 11911196. doi:10.1093/gerona/gls117.Google Scholar
Zaslavsky, O., Cochrane, B. B., Herting, J. R., Thompson, H. J., Woods, N. F. and Lacroix, A. (2014). Application of person-centered analytic methodology in longitudinal research: exemplars from the Women's Health Initiative clinical trial data. Research in Nursing and Health, 37, 5364. doi:10.1002/nur.21575.Google Scholar
Supplementary material: File

Zaslavsky Supplementary Material

Supplementary Material

Download Zaslavsky Supplementary Material(File)
File 85.1 KB