title: Multidimensional health-transition patterns among a middle-aged and older population.
abstract: OBJECTIVE
  Previous studies on health transition have focused on single-dimension outcomes and minimally evaluated heterogeneity. This study aimed to explore heterogeneous and multidimensional health-transition patterns on comorbidity, frailty and disability while examining the factors predicting different patterns of health transition.
  
  
  METHODS
  This study drew on data from a nationwide and longitudinally-followed sample of 5131 Taiwanese aged 50 years and older who were interviewed in 1996, 1999, 2003 and 2007. Latent class analysis (LCA) and multinomial logistic regression were applied to identify health-transition patterns and their predictors.
  
  
  RESULTS
  We identified six health-transition classes by applying LCA, including "persistently healthy", "well-managed comorbidity", "originally comorbid and gradually deteriorating to disability", "deteriorating gradually and died in late stage of the follow-up period", "deteriorating and died in middle stage of the follow-up period", and "originally comorbid and died in early stage of the follow-up period". Using the "well-managed comorbidity" class as the reference group, men had higher probabilities of being in the categories of dying in the follow-up period, but a lower risk of deteriorating to disability. Younger baseline age, higher education, having social engagement and non-smoking were predictors of "persistently healthy" and were associated with a lower risk of deteriorating to disability and death. Having a spouse and health examinations were associated with a lower risk of death, and also a lower probability of "persistently healthy".
  
  
  CONCLUSIONS
  Heterogeneous and multidimensional health-transition patterns exist in middle-aged and older populations. Several factors might have an effect on health-transition patterns.
authors.affiliation: Institute of Health Policy and Management, College of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wen-Chiung
authors.initials: WC
authors.lastname: Chang
authors.forename: Feng-Ping
authors.initials: FP
authors.lastname: Lu
authors.forename: Tzuo-Yun
authors.initials: TY
authors.lastname: Lan
authors.forename: Shwu-Chong
authors.initials: SC
authors.lastname: Wu
mesh_terms: D000368:Aged; D000375:Aging; D015897:Comorbidity; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006304:Health Status; D019456:Health Transition; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology