Social Stratification and Trajectories of Functional Status among Older Taiwanese

Objectives: With a person-centered approach, this research aims to depict distinct courses of functional disability among older Taiwanese and to ascertain disparities in the probabilities of experiencing these trajectories. Methods: Data was derived from a sample of 3,975 Taiwanese aged 60 and over, initially surveyed in 1989 and subsequently surveyed in 1993, 1996, 1999, and 2003. Group based, semi-parametric mixture models (Proc Traj) were employed to identify distinct trajectories of functional status. Results: Four major trajectories were identified: (1) excellent functional health (48.2%), (2) moderate increase in disability (35.5%), (3) accelerated increase in disability (10.7%), and (4) persistent severe disability (5.6%). Older age, female gender and lower education were associated with greater odds for poor functional trajectories. In addition, there were some ethnic differences, which could be explained by education. Conclusion: Distinct trajectories of functional health paralleling successful, usual, and pathological aging exist among older Taiwanese. The social stratification of functional trajectories among older Taiwanese resembles those observed among older Americans.