Abstract
BackgroundResearchers have emphasized the importance of examining how different factors affect men’s and women’s functional status over time. To date, the literature is unclear about whether sex affects the rate of change in disability in middle to older age. Researchers have further emphasized the importance of examining how different factors affect men’s and women’s functional status over time. We examined (a) sex differences in disability trends and (b) the determinants of the rate of change in disability for men and women 50 years and older.MethodsThis study utilized the Taiwan Longitudinal Study on Aging Survey, a nationally representative database (four waves of survey data 1996–2007, N = 3429). We modeled and compared the differences in disability trends and the influences of determinants on trends among men and women using multiple-indicator and multiple-group latent growth curves modeling (LGCM). Equality constraints were imposed on 10 determinants across groups.ResultsOnce disability began, women progressed toward greater disability 18% faster than men. Greater age added about 1.2 times the burden to the rate of change in disability for women than men (p < 0.001). More comorbidities also added significantly more burden to baseline disability and rate of change in disability among women than men (p < 0.001), but women benefited more from higher education levels in lower baseline disability and slower rate of change. Having a better social network was associated with lower baseline disability among women only (p < 0.05). For both men and women, physically active leisure-time activities were beneficial in lower baseline disability (pmen and women < 0.001) and rate of change in disability (pmen < 0.01; pwomen < 0.05), with no significant differences between groups.ConclusionsAge may widen the sex gap in the rate of change in disability. However, both sexes benefit from participating in leisure-time activities. Promoting health literacy improves health outcomes and physical function among women.
Highlights
Researchers have emphasized the importance of examining how different factors affect men’s and women’s functional status over time
Studies have shown that sex differences in functional status among older adults reflect biological differences and differences in privilege and power based on sex identity and past decision making [13, 15, 27, 33, 39, 51]
Factors that influence disability trends by sex Our analysis examined 10 determinants—age, education level, number of comorbidities, depression, alcohol consumption, recreational and physically active leisure-time activities, social network, social relations, and use of assistive devices—that have been reported in earlier studies to influence older adults’ disability trends [10]
Summary
Researchers have emphasized the importance of examining how different factors affect men’s and women’s functional status over time. The literature is unclear about whether sex affects the rate of change in disability in middle to older age. We examined (a) sex differences in disability trends and (b) the determinants of the rate of change in disability for men and women 50 years and older. Researchers have further emphasized the importance of examining how different factors affect men’s and women’s functional status over time [10, 27, 57, 58]. When Liang et al [26] examined functional changes over time among middle-aged and older men and women from a life course perspective, they found that decreases in functional status were more accelerated—in terms of both baseline disability and rate of change in disabilities—among women than men. How much faster women’s rate of change in disability may be remains unclear
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