Yu H.-W.YU-KANG TUYA-MEI CHEN2021-03-262021-03-2620190167-4943https://www.scopus.com/inward/record.uri?eid=2-s2.0-85061799173&doi=10.1016%2fj.archger.2019.01.019&partnerID=40&md5=0c8e887bb876aee5d8a2fd2f6dc1faddhttps://scholars.lib.ntu.edu.tw/handle/123456789/555338Objectives: To understand whether disability trajectories mediated the association between sociodemographic characteristics and later health care and long-term care services use. Methods: Data were from the Taiwan Longitudinal Study on Aging Survey, 1996–2007 (N =3429). Latent class growth curves modeling and structural equation modeling were applied to examine the effect of disability trajectory as mediator on sociodemographic characteristics and on later services use. Results: Respondents were identified in three trajectories: maintained disability (1.92%), progressive disability (10.56%), and functional independence trajectories (87.52%). The progressive disability trajectory partially and fully mediated the effects of age on later use of health care and long-term care services (the partially mediating effect on age and long-term care service use: β = 0.047, p < 0.001, for example). With the progressive disability trajectory in the model, higher education had a direct effect on greater use of long-term care services (β = 0.020, p =0.020), but through the mediating effect of the disability trajectory, education had an indirect effect on lower use of long-term care services(β = -0.025, p < 0.001). Education had fully mediating effects on the later use of inpatient (β = -0.016, p < 0.001) and emergency services (β= -0.012, p < 0.001). Conclusions: Preventing older adults from developing a fast-growing disability trajectory could be an effective way to decrease use of health care and long-term care services and related expenditures in late life. ? 2019 Elsevier B.V.[SDGs]SDG2[SDGs]SDG3[SDGs]SDG4[SDGs]SDG5adult; age; Article; correlational study; disability; educational status; emergency health service; female; functional status; gender; growth curve; health care utilization; hospital patient; human; independence; long term care; longitudinal study; major clinical study; male; middle aged; population risk; priority journal; risk factor; social status; Taiwan; trend study; aged; daily life activity; disabled person; disease exacerbation; long term care; socioeconomics; Activities of Daily Living; Aged; Disabled Persons; Disease Progression; Emergency Medical Services; Female; Humans; Long-Term Care; Longitudinal Studies; Male; Middle Aged; Socioeconomic Factors; Taiwanjournal article10.1016/j.archger.2019.01.019308028402-s2.0-85061799173