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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 31905 Israel. Phone: +972-48288749; Fax: +972-48288017. Email: oleg.zaslavsky@fulbrightmail.org.

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 

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