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Ageing and functioning: understanding trajectory analysis and its applicability

Grant number: 18/02401-6
Support type:Scholarships abroad - Research Internship - Doctorate
Effective date (Start): August 01, 2018
Effective date (End): July 31, 2019
Field of knowledge:Health Sciences - Collective Health
Principal Investigator:José Leopoldo Ferreira Antunes
Grantee:Etienne Larissa Duim Negrini
Supervisor abroad: Valeria Lima Passos
Home Institution: Faculdade de Saúde Pública (FSP). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Local de pesquisa : Maastricht University, Maastricht (UM), Netherlands  
Associated to the scholarship:16/19696-3 - Ageing and functional ability: an analysis of trajectories, BP.DR


Abstract of Research PlanBackgroundLocal and global estimates and projections of elderly population highlight a process of demographic transition that had never been observed before. This process is more accelerated in developing countries characterized by great social inequality that impact the conditions of ageing.ObjectiveIn my project, I intend to explore trajectories of functioning of Brazilian older adults. The following is a brief guidance for the project methodology: Currently, I am part of a research group called Health, Well-being and Ageing - SABE Survey. This is an epidemiological research of multiples cohorts, which started in 2000 and at the moment is in its fourth wave. To highlight the goals of functioning on trajectory of ageing and its impact on elderly health, I will conduct a literature review on this topic and thereafter run model-based clustering analyses using the database of Brazilian older adults that participated in all four waves of the study. The aim of my PhD project is to identify sub-groups of individuals with similar ageing trajectories based on their functional condition. Subsequently, I will investigate how social determinants of health, health conditions, and behaviors, as well as early life experiences, can impact the probability of being part of a specific trajectory group. Synthesis & AnalysisBased on the objectives identified in the previous step, the research will focus on two outcomes of functioning, based on self-reported activities of basic and instrumental daily living. I would like to apply the relatively innovative methodology of Group-Based Trajectory Models to identify specific trajectories of functioning in this population. After uncovering the functional trajectories, I will attempt to establish links between them and five groups of covariates: 1) Demographics variables, 2) Socioeconomics, 3) Variables related with early life condition, 4) Behavioral aspects, 5) Health conditions and health assistance/services.Each outcome variable will be analyzed separately, giving rise to clusters of individuals with similar functional characteristics of ageing. I will also consider a multivariate approach, in which trajectory extraction occurs by taking patterns of temporal co-dependencies of the two outcomes simultaneously. Moreover, I will conduct statistical analysis to identify factors associated with each (multi)-trajectory of aging for the functional outcomes proposed. There are different statistical approaches to conduct a trajectory analysis and I believe under the supervision of Dr. Lima Passos, at Maastricht University, I will learn about these methods and identify the one that best fits my research. Expected Objectives during the PhD SandwichÏTo prepare the four waves of SABE Survey (database) to be analyzed during the sandwich; ÏTo understand the modus operante, that concerns applicability and methodology of "Group-Based Trajectory Models (GBTM)";ÏTo apply the concepts of GBTM to identify trajectories of functioning based on Activities of Daily Living of Brazilian older adults;ÏTo apply the concepts of GBTM to identify trajectories of functioning based on Instrumental Activities of Daily Living of Brazilian older adults;ÏTo apply the concepts of GBTM to identify bivariate trajectories of functioning based on Activities of Daily Living and instrumental activities of Daily Living of Brazilian older adults;ÏTo write a methodological paper about applicability of GBTM for the analysis of ageing populations, starting the collaboration between Prof José Leopoldo Ferreira Antunes (USP), Dr. Valeria Lima Passos (UM) and me (USP);ÏTo write a paper about Trajectory of Functioning of Brazilian older adults, highlighting the social determinants of health and its power of prediction to be part of a specific trajectory.