Disability Trajectories at the End of Life: A "Countdown" Model

The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
Douglas A WolfBrenda C Spillman

Abstract

Studies of late-life disablement typically address the role of advancing age as a factor in developing disability, and in some cases have pointed out the importance of time to death (TTD) in understanding changes in functioning. However, few studies have addressed both factors simultaneously, and none have dealt satisfactorily with the problem of missing data on TTD in panel studies. We fit latent-class trajectory models of disablement using data from the Health and Retirement Study. Among survivors (~20% of the sample), TTD is unknown, producing a missing-data problem. We use an auxiliary regression equation to impute TTD and employ multiple imputation techniques to obtain final parameter estimates and standard errors. Our best-fitting model has 3 latent classes. In all 3 classes, the probability of having a disability increases with nearness to death; however, in only 2 of the 3 classes is age associated with disability. We find gender, race, and educational differences in class-membership probabilities. The model reveals a complex pattern of age- and time-dependent heterogeneity in late-life disablement. The techniques developed here could be applied to other phenomena known to depend on TTD, such as cognitive change, weight...Continue Reading

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Citations

Oct 6, 2016·The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences·Ivan R Molton, Kathryn M Yorkston
Sep 4, 2015·The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences·Linda G MartinJinkook Lee
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Jun 6, 2020·Health & Social Care in the Community·Alejandro de la Torre-LuqueJose Luis Ayuso-Mateos
Sep 14, 2018·Forum for Health Economics & Policy·Emily M Agree, Douglas A Wolf
Oct 11, 2017·Forum for Health Economics & Policy·Jody Schimmel Hyde, David C Stapleton
Jun 2, 2017·Research on Aging·Lois M VerbruggePhilippa J Clarke
Oct 5, 2017·The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences·Kim M Shuey, Andrea E Willson
Nov 14, 2019·Journal of Aging and Health·Ivan R Molton, Anne Ordway
Feb 7, 2021·International Journal of Environmental Research and Public Health·Keith T ChanTarek Zidan
Feb 23, 2020·Journal of the American Medical Directors Association·Bettina MeinowSusanne Kelfve
Jun 29, 2021·The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences·Ignacio Madero-CabibJorge Browne Salas
Sep 8, 2021·Journal of the National Comprehensive Cancer Network : JNCCN·Chetna MalhotraEric Finkelstein

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