Toward a multidimensional understanding of later life disability: A latent profile analysis

Abstract

Disability is difficult to define succinctly. Current literature on disability has primarily focused on physical functioning limitations. However, relying on a single dimension or index cannot accurately represent disability as the experience of disability is complex. To address these gaps, this study aims to understand the multidimensional nature of disability among retired, community-dwelling older adults. Using a sample of 414 older adults between the ages of 72 and 106 years (M=84.84, SD=4.56), latent profile analysis was employed to identify classes based on five indicators of disability across three domains. The five indicators of disability included difficulties with activities of daily living (ADLs), cognitive impairment, physical impairment, sensory impairment, and participation restrictions. Three classes were found to represent the data best. The Low Disability group comprised the highest number of participants (n=242, 60%). The High Physical Impairment and ADL-difficulty profile (n=157, 40%) was characterized by high physical impairment as well as relatively high ADL-difficulty. The smallest group, Poor Cognitive, Sensory, and ADL Functioning (n=15, 4%), had drastically higher cognitive impairment than all of the other groups, along with high ADL-difficulty and sensory impairment. Multinomial logistic regression and chi-square tests revealed that class membership was related to sociodemographic characteristics. Finally, class membership predicted several mental health outcomes such as depressive symptoms, positive affect, and life satisfaction in the expected direction. If supported by future work, these findings could inform practitioners in developing more specific interventions relevant to older adults based on their disability profiles. Understanding various combinations of disablement has potential implications for services and interventions to be tailored to individuals' distinct disability-related needs.