Understanding the Disability Dynamics of Youth: Health Condition and Limitation Changes for Youth and Their Influence on Longitudinal Survey Attrition.

Disability status-experiencing a functional limitation caused by a health condition-is dynamic throughout the life cycle, even during adolescence and young adulthood. We use data from the 1997 cohort of the National Longitudinal Survey of Youth to better understand these dynamics, examining how health condition and limitation statuses evolve during adolescence and young adulthood as well as how changes in these characteristics are related to survey nonresponse and attrition. Health condition and limitation dynamics are evident in our data: the proportion of sample members who reported having a limitation in their activities for any interview increased from approximately 12 % during the initial interview (when sample members were 12 to 17 years old) to almost 25 % 13 years later. Multivariate analyses revealed that women are more likely than men to report changes in health condition or limitation status. Those with mild limitations were relatively less likely than those without limitations or with severe limitations to experience changes in limitation status. Somewhat surprisingly, a survival analysis of survey participation outcomes found limited correlation among health conditions, limitations, and either missing a survey interview for the first time or permanently leaving the survey sample.

One-Year Disability Trajectories and Long-Term Cardiovascular Events, Recurrent Stroke, and Mortality After Ischemic Stroke.

BACKGROUND: Patients with stroke are often affected by varying degrees of functional disability and have different evolution patterns in functional disability. However, little is known about the predictive usefulness of disability changes after stroke. We aimed to describe 1-year disability trajectories and to assess the associations of longitudinal disability trajectories with 24-month clinical outcomes after ischemic stroke. METHODS AND RESULTS: A total of 3533 patients with ischemic stroke from CATIS (China Antihypertensive Trial in Acute Ischemic Stroke) were studied. Distinct trajectories of disability were identified by the group-based trajectory model, as measured by modified Rankin Scale score within 12 months. Cox proportional hazards regression models were used to examine the associations of disability trajectories with 24-month cardiovascular events and all-cause mortality. We identified 4 distinct disability trajectories: no significant disability (562 participants [15.9%]), slight disability to recovery (1575 participants [44.6%]), severe to moderate disability (1087 participants [30.8%]), and persistent severe disability (309 participants [8.7%]). Compared with no significant disability trajectory, the multivariable adjusted hazard ratios (95% CIs) of patients within the persistent heavy-severe trajectory were 2.63 (1.20-5.76) for cardiovascular events, 2.55 (1.12-5.79) for recurrent stroke, and 6.10 (2.22-16.72) for all-cause mortality; notably, the hazard ratios (95% CIs) for patients within the severe to moderate disability trajectory were 1.99 (1.01-3.94) for cardiovascular events and 1.85 (1.03-3.33) for the composite outcome of cardiovascular events and all-cause mortality. CONCLUSIONS: Functional disability trajectories within 12 months after stroke onset were associated with the risk of 24-month adverse outcomes. Patients with persistent severe disability or severe to moderate disability had higher risk of cardiovascular events and all-cause mortality. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01840072.