AUTHOR=Mielenz Thelma J. , Kannoth Sneha , Xue Qian-Li
TITLE=Patterns of Self-Care Behaviors and Their Influence on Maintaining Independence: The National Health and Aging Trends Study
JOURNAL=Frontiers in Aging
VOLUME=2
YEAR=2021
URL=https://www.frontiersin.org/journals/aging/articles/10.3389/fragi.2021.770476
DOI=10.3389/fragi.2021.770476
ISSN=2673-6217
ABSTRACT=Importance: Few studies have addressed the combined effects of health-promoting and self-care behaviors among older adults. Thus, new research is needed to assess the potential for behavior change to prolong independence in later life.
Objectives: To determine the relationships between self-care behaviors and risks of mobility and activities of daily living (ADLs) over time.
Design: Longitudinal data was used from the National Health and Aging Trends Study (NHATS) cohort. Eight baseline self-care behaviors were summarized using latent class analysis. Separately, longitudinal latent classes of mobility and ADLs were created.
Setting: Annual in-person interviews conducted for a nationally representative sample.
Participants: The baseline study sample included 7,609 Medicare beneficiaries aged ≥65 from NHATS who were living in community or residential care settings, with a 71% response rate. The average age was 75, with 57% female, 81% white and 78% high school graduates or higher. Approximately, 80% (n = 6,064) completed 5 years of follow-up.
Exposures: Favorable vs. unfavorable self-care latent classes measured at baseline.
Main outcomes and Measures: Associations were measured between baseline classes and longitudinal classes of mobility and ADLs difficulty. Among decedents, 5-year associations were measured between baseline classes and years of overall, healthy, able, and healthy/able life.
Results: Two habitual baseline self-care behavioral patterns (46% favorable; 54% unfavorable) and three trajectories of change in mobility and ADLs disability (maintaining independence; shifting to accommodation/difficulty; shifting to assistance) emerged over time. Participants with a favorable baseline pattern had 92% (0.90–0.94) reduced risk in shifting to assistance class and 70% (0.64–0.76) reduced risk for shifting to accommodation/difficulty class for mobility disability. Participants with a favorable baseline pattern had 86% (0.83–0.89) reduced risk in shifting to assistance class and 24% (0.11–0.36) reduced risk in shifting to accommodation/difficulty class for ADLs disability. Those with an unfavorable pattern had 2.54 times greater risk of mortality by the end of the 5-year follow-up compared to those with a favorable pattern.
Conclusion: Self-care behaviors in older age represent a habitual pattern. A favorable self-care behavioral pattern decreased the risk of moving towards a more disabled profile and added years of life. Interventions should encourage self-care behaviors constituting a favorable pattern.