Psychological distress, cognition and functional disability trajectory profiles of aging in primary care older adults

Objectives: To identify profiles of aging combining psychological distress, cognition and functional disability and their associated factors. Methods: Data were drawn from the Étude sur la Santé des Aînés-Services longitudinal study and included 1585 older adults ≥ 65 years. Socio-demographic, psychosocial, lifestyle, physical, mental health were informed from structured interviews. Group-based multi-trajectory modelling and multinomial logistic regression were used to identify aging profiles and correlates. Sampling weights were applied to account for the sampling plan. Results: The weighted sample size was of 1591.Three trajectories were identified: a favorable (79.0%), intermediate (14.5%) and severe scenario (6.5%). Factors associated with the severe scenario were older age, male gender, lower education, the presence of anxiety disorders, low physical activity and smoking. Membership in the intermediate scenario was associated with daily hassles, chronic physical disorders, anxio-depressive disorders, antidepressants/psychotherapy use, low physical activity and no alcohol use. High social support was protective against less favorable profiles, as was primary care recruitment site. Conclusions: Symptoms of anxiety and depression and a high burden of chronic physical disorders were associated with less favorable trajectories. Modifiable lifestyle factors have a significant effect on healthy aging. Clinical implications: Assessment and management of anxiety and depressive symptoms are important in older adults. Clinical interventions including access to psychotherapy and promotion of healthier lifestyles should be considered.