Functioning in Older Adults with Chronic Diseases: Trajectories and Associated Factors

Knowledge about the development of functioning in older age is crucial to design targeted interventions to maintain good health in older adults. The aim of this study was to investigate the time-trajectories of functioning and its domains (Cognition, Mobility, Self-Care, Getting along, Life Activities, and Participation) over time in a community sample of older people with chronic health conditions. Additionally, the study sought to identify factors differentially associated with these trajectories.

A total of n=491 individuals aged 65 years and older with chronic health conditions answered the WHO Disability Assessment Schedule 2.0 questionnaire three times over a 1.5-year period (at T2 n=309). Linear Mixed Effects Models and pairwise comparisons of the slopes of the questionnaires different subscales were used to analyse trajectories over time and to identify associated factors.

The results revealed a general decline in functioning over time across all domains, with the exception of Participation. Significant differences were observed between the trajectory coefficients of certain domains. While depressive symptoms displayed comparable associations with all domains of functioning, gender and age exhibited divergent associations with functioning across domains.

The results emphasize the importance of a nuanced understanding of how functioning develops across different domains in older age. This can contribute to targeted prevention and support programs for older adults at risk and help maintain good health in older age among those with chronic conditions.