Mobility Trajectories at the End of Life: Comparing Clinical Condition and Latent Class Approaches

Mobility Trajectories at the End of Life: Comparing Clinical Condition and Latent Class Approaches In the 1960s, sociologists Glaser and Strauss observed people dying in a hospital setting and described different trajectories of dying: abrupt, surprise deaths; expected deaths (short‐ and long‐term); and entry‐reentry deaths. A graphical representation of these ideas was included in the Institute of Medicine 1997 report Approaching Death, and clinicians widely accepted the scheme as congruent with their own experience. Our early research provided empirical support for the classification scheme, but more recent work has challenged the usefulness of clinical groupings using latent trajectory modeling of disability to illustrate that the course of disability in the last year of life does not follow a predictable pattern based on the condition leading to death. We conducted a head‐to‐head comparison of the 2 approaches using the same data from a single sample of decedents to determine the degree to which previous findings were the result of approach rather than decedent characteristics.MethodsSampleWe derived our sample from the Health, Aging and Body Composition (Health ABC) panel study. Participants were recruited by mail in 1997–98 from a random sample of white Medicare beneficiaries and all black community residents in Pittsburgh, Pennsylvania, and Memphis, Tennessee, who met the age criteria. At baseline, the 3,075 participants http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of American Geriatrics Society Wiley

Mobility Trajectories at the End of Life: Comparing Clinical Condition and Latent Class Approaches

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 American Geriatrics Society and Wiley Periodicals, Inc.
ISSN
0002-8614
eISSN
1532-5415
D.O.I.
10.1111/jgs.15224
Publisher site
See Article on Publisher Site

Abstract

In the 1960s, sociologists Glaser and Strauss observed people dying in a hospital setting and described different trajectories of dying: abrupt, surprise deaths; expected deaths (short‐ and long‐term); and entry‐reentry deaths. A graphical representation of these ideas was included in the Institute of Medicine 1997 report Approaching Death, and clinicians widely accepted the scheme as congruent with their own experience. Our early research provided empirical support for the classification scheme, but more recent work has challenged the usefulness of clinical groupings using latent trajectory modeling of disability to illustrate that the course of disability in the last year of life does not follow a predictable pattern based on the condition leading to death. We conducted a head‐to‐head comparison of the 2 approaches using the same data from a single sample of decedents to determine the degree to which previous findings were the result of approach rather than decedent characteristics.MethodsSampleWe derived our sample from the Health, Aging and Body Composition (Health ABC) panel study. Participants were recruited by mail in 1997–98 from a random sample of white Medicare beneficiaries and all black community residents in Pittsburgh, Pennsylvania, and Memphis, Tennessee, who met the age criteria. At baseline, the 3,075 participants

Journal

Journal of American Geriatrics SocietyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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