The Longitudinal Relationship between the Trajectories of Functional Disability and Informal Care Intensity in Chinese Older Adults

Author : Man-Man Peng, Pengfei Wang'

Abstract : Aims: This study aims to provide longitudinal evidence on how trajectories of Instrumental Activities of Daily Living (IADL) disability affect informal care intensity, and how this relationship may vary by multimorbidity and gender in the Chinese context. Methods: Using three waves of data from the Chinese Longitudinal Healthy Longevity Survey, we analyzed 1,226 participants aged 60 and older. We employed Group-Based Trajectory Modeling to identify IADL trajectories. Multinomial logistic regression was used to examine the relationships between IADL trajectories and informal care intensity, stratifying the analysis by multimorbidity and gender. Results: Compared with the stable low group, the increasing trajectory was associated with a significantly higher predicted need for low-to-moderate and high-intensity care. For those with somatic or mental-somatic multimorbidity, it was only predictive of high intensity care, with the most pronounced effect observed in the latter group. For female older adults, an increase in IADL disability was linked to a greater intensity of informal care, irrespective of multimorbidity status. By contrast, for males, significant associations were observed only among those without multimorbidity or those with somatic multimorbidity. Conclusions: The decline in IADL over time results in a heightened demand for informal care among older adults in China, with multimorbidity patterns and gender moderating this relationship. These findings underscore the critical need for early screening of functional disabilities, integrated management of somatic and mental conditions, and the development of gender-sensitive strategies to alleviate the increasing burden of informal care, particularly in the context of rapid population aging

Keywords : IADL disability, informal care, older adults, multimorbidity, gender differences, aging, and long-term care.

Conference Name : International Conference on Neuropsychology, Psychiatry and Mental Health (ICNPMH - 26)

Conference Place : Wellington, New Zealand

Conference Date : 2nd Jun 2026