- Three distinct 10-year SRH trajectories identified: low-health 7.3%, moderate-health 48.8%, high-health 43.9%.
- High-health trajectory associated with lower hypertension, diabetes, arthritis; regular exercise; higher life satisfaction; economic activity; social participation; lower depression.
- Analysis framed by Roy's Adaptation Model using group-based trajectory modelling; observational design, no tests for interactions, mediation, or causality.
Inquiry. 2026 Jan-Dec;63:469580261497782. doi: 10.1177/00469580261497782. Epub 2026 Oct 18.
ABSTRACT
IntroductionUsing Roy’s Adaptation Model, this study identified self-rated health (SRH) trajectories among late middle-aged adults and examined baseline (Wave 5) factors associated with trajectory-group membership.MethodsThis secondary analysis used Korean Longitudinal Study of Aging waves 5-10 (2014-2024). Group-based trajectory modeling was applied to 2,680 adults aged 51-64 years with at least three valid SRH responses; 428 participants lacking a valid integrated longitudinal weight (for complex-samples analyses) were excluded, yielding a final subsample of 2,252 for multinomial logistic regression incorporating sampling weights and the complex survey design.ResultsThree SRH trajectories emerged: low-health (7.3%), moderate-health (48.8%), and high-health (43.9%). Compared with the low-health group (reference), high-health group had lower hypertension, diabetes, and arthritis prevalence, and more favorable contextual stimuli (older age, lower odds; higher education, higher odds). Among adaptation-related factors, high-health group was positively associated with regular exercise (OR=2.13, 95% CI 1.26-3.60, ref: no exercise), higher life satisfaction (OR=1.04, 95% CI 1.02-1.06), economic activity (OR=2.03, 95% CI 1.23-3.35, ref: inactive), and social participation (OR=2.37, 95% CI 1.62-3.46), and negatively with depression (OR=0.86, 95% CI 0.75-0.99). Current drinking (OR=1.90, 95% CI 1.18-3.05, ref: non-drinker) and overweight status (OR=1.79, 95% CI 1.03-3.11, ref: normal weight) were unexpectedly and positively associated with this trajectory, an observational finding warranting caution.ConclusionThese cross-sectional associations align with the physiologic, self-concept, role function, and interdependence modes described by Roy’s Adaptation Model, but interactions, mediation, and causal mechanisms were not tested.
PMID:42893427 | DOI:10.1177/00469580261497782
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