Distinct physical activity and sedentary behavior trajectories in older adults during participation in a physical activity intervention: a latent class growth analysis

Background This study aimed to identify latent moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior (SB) trajectories in older adults participating in a randomized intervention trial and to explore associations with baseline social-cognitive predictors. Methods Data were assessed at baseline (T0, participants were inactive or had recently become active), after a ten-week physical activity intervention (T1), and a second 24-week intervention phase (T2). Latent class growth analysis was used on accelerometer-assessed weekly MVPA and daily SB, respectively (n = 215 eligible participants). Activity changes within trajectory classes and baseline social-cognitive predictor differences between trajectory classes were analyzed. Results A “stable insufficient MVPA” (n = 197, p for difference in MVPA level at T0 and T2 (pT0-T2) = .789, effect size (Cohen’s d) = .03) and a “stable high MVPA” trajectory (n = 18, pT0-T2 = .137, d = .39), as well as a “slightly decreasing high SB” (n = 63, p for difference in SB (pT0-T2) = .022, d = .36) and a “slightly increasing moderate SB” trajectory (n = 152, pT0-T2 = .019, d = .27) emerged. Belonging to the “stable high MVPA” trajectory was associated with higher action planning levels compared to the “stable insufficient MVPA” trajectory (M = 5.46 versus 4.40, d = .50). Belonging to the “decreasing high SB” trajectory was associated with higher action self-efficacy levels compared to the “increasing moderate SB” trajectory (M = 5.27 versus 4.72, d = .33). Conclusions Change occurred heterogeneously in latent (not directly observed) subgroups, with significant positive trajectories only observed in the highly sedentary. Trial registration German Registry of Clinical Trials, DRKS00016073, Registered 10 January 2019.

The influence of multidimensional deprivation on problem drinking developmental trajectory among young adults: a longitudinal study using latent class growth analysis

Background Many young people in Korea today experience deprivation in various areas of life. The social determinants of health approach maintains that social factors play an important role in an individual’s physical and mental health. This study aimed to investigate the problem drinking trajectory of young Korean people and identify the effects of multidimensional deprivation on problem drinking. Methods The study used data from 2012 to 2018 found in the Korea Welfare Panel Study. Latent class growth analysis was performed to determine the number of trajectories of problem drinking. After identifying latent classes, a multinomial logistic regression analysis was utilized to examine multidimensional deprivation as a predictor of class membership. Results Latent class analysis yielded three groups: (1) a low-level maintenance group (low level of alcohol use maintained at the low level), (2) a moderate-level increasing group (moderate level of problem drinking with a moderate increase in problem drinking), and (3) a risky drinking increasing group (high level of problem drinking with a rapid increase in problem drinking). Results from multinomial logistic regression showed that deprivation in housing and social deprivation increased the probability of belonging to the risky drinking increasing group compared to other reference groups. Conclusion The study speaks to the need to establish appropriate intervention strategies according to the level and changes in the pattern of alcohol use. The implications of housing and social deprivation concerning problem drinking among young Korean people are also discussed.

Patients Reported Outcomes Measures (PROMs) Trajectories After Elective Hip Arthroplasty: A Latent Class Growth Analysis

Background. Patient-Reported Outcome Measures (PROMs) are an extensively used tool to assess and improve the quality of healthcare services. PROMs are affected by individual characteristics in patients undergoing hip arthroplasty (HA). The aim of this study is to identify distinct groups of patients with unique score-trajectories using the Latent Class Growth Analysis (LCGA) technique and to determine patients’ features associated with these groups.Methods. We conducted a prospective, cohort study analyzing PROMs questionnaires (Euro Quality 5 Dimensions 3L, EQ-5D-3L, Euro-Quality-Visual-Analytic-Score, EQ-VAS, Hip disability and Osteoarthritis Outcome Score, HOOS-PS) administered to patients undergoing elective HA at successive time points. For each score, LCGA was carried out to identify subgroups of patients assessed pre-operatively, and at 6 and 12 months after HA. Multinomial logistic regression was used to identify the demographic and clinical characteristics associated with the latent trajectories.Results. We identified three distinct trajectories for each PROM score. These trajectories indicated high response heterogeneity to the HA among the patients (n=991): one trajectory showing an improvement at 6 months followed by a plateau, a second trajectory showing a lower starting level followed by a consistent improvement, and a third trajectory showing a modest improvement at 6 months followed by a modest decline at 12 months. Patient’s gender, ASA score ≥3, obesity and the main diagnosis were significantly associated with different PROMs trajectories.Conclusions. These findings underline the importance of patient-centered care, supporting the usefulness of integrating PROMs data alongside routinely collected healthcare records for guiding clinical care and maximizing patient outcomes. Trial registration number: Protocol version (1.0) and trial registration data are available on the platform www.clinicaltrial.gov with the identifier NCT03790267, posted on December 31, 2018.

Irritability, Defiant and Obsessive-Compulsive Problems Development from Childhood to Adolescence

Little is known about the coexistence of oppositionality and obsessive-compulsive problems (OCP) in community children and how it affects their development until adolescence to prevent possible dysfunctions. The co-development of oppositional defiant dimensions and OCP is studied in 563 children (49.7% female) from ages 6 to 13 years, assessed yearly with measures answered by parents and teachers. A 4-class model based on Latent Class Growth Analysis for three parallel processes (irritability, defiant, and OCP) was selected, which showed adequate fitting indexes. Class 1 (n = 349, 62.0%) children scored low on all the measures. Class 2 (n = 53, 9.4%) contained children with high OCP and low irritability and defiant. Class 3 (n = 108, 19.2%) clustered children with high irritability and defiant and low OCP. Class 4 (n = 53, 9.4%) clustered comorbid irritability, defiant, and OCP characteristics. The classes showed different clinical characteristics through development. The developmental co-occurrence of irritability and defiant plus obsessive-compulsive behaviors is frequent and adds severity through development regarding comorbidity, peer problems, executive functioning difficulties, and daily functioning. The identification of different classes when combining oppositional problems and OCP may be informative to prevent developmental dysfunctions and to promote good adjustment through development.

Trends and Inequalities in Extending Working Lives: Late-Life Employment Trajectories between 1990-2019 in Seven Countries

Public policies encourage later retirement, but they often do not account for discrepancies in the capacity for extending working lives. This paper studies trends and inequalities in extending working lives over the last three decades in a gender-specific and comparative perspective of seven countries (Australia, Germany, Russia, South Korea, Switzerland, United Kingdom, United States). We apply latent class growth analysis to identify employment trajectories between 60 and 69 from 1990 to 2019. In particular, we focus on people who continue work till later ages and compare them with those who exit early and remain inactive through their 60s. Latent class regression models serve to measure gender differences, educational inequalities, and time trends. We find five universal trajectories: Late Employment, Standard, Early and Late Exit, and Non-Employment. Non-Employment dominated the 1990s, but it significantly declined, giving space to Late Employment as one of the major employment pathways. Gender and educational inequalities are considerable and stable. Progress toward later employment is universal for contemporary societies, however, we find vital differences between countries, which warns against generalizations of one-country findings. This study also contributes methodologically by exploring the trajectory-oriented perspective on late careers.