Functional Status Trajectories and Predictors of Long-Term Functional Outcomes in Older Adults after Injury

Background: The study’s objective was to investigate trajectories of long-term functional status after injury in the older adult population in order to better characterize the recovery process. Baseline characteristics of individuals belonging to different functional status trajectories were examined to determine which individuals are most at risk for not reaching full recovery. Methods: The analysis used six waves of data from the Health and Retirement Study (HRS), a longitudinal panel study that surveys Americans over the age of 50 every two years. Individuals that reported any type of injury in the 2000 survey were included in the study sample. Functional limitations score was the outcome variable used in the analysis. Trajectories were determined by fitting a group-based trajectory model (GBTM) to the data. Multivariate regression analysis was used to identify significant predictors of each trajectory class. Results: Five distinct functional trajectories were identified: Trajectory 1– consistently low functional limitations scores (18.9%), Trajectory 2– increase in functional limitations after injury followed by a gradual, but not complete recovery (46.3%), Trajectory 3– increase in functional limitations followed by further decline in functioning over time (10.5%), Trajectory 4– increase in functional limitations after injury followed by a gradual, complete recovery (13.4%), and Trajectory 5- consistently high functional limitations scores (10.8%). Regression analyses showed that women, individuals with multiple health conditions, and individuals with no insurance and public insurance were more likely to belong to trajectories with poorer functional outcomes. Conclusions: Functional status after injury follows distinct trajectories that can be predicted by baseline patient characteristics.