Abstract: Older women are at a high risk of disability. Using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018, this study identifies the trajectories of activities of daily living and cognition of older women in China through a group-based trajectory model and its extended model. It also compares the disparities in disability trajectories and their influencing factors between urban and rural areas and across cohorts. The results show three categories for the activities of daily living trajectories of older Chinese women: stable throughout life, risky in later life, and high-risky throughout life. There are two cognitive trajectories: low-starting risk and high-starting risk. The joint identification results show that the probability of experiencing both the activity of daily living impairment and cognitive impairment is as high as 0.109 for older women. Social capital, social security, childhood adverse experiences, and health behaviors affect older women’s disability trajectories. The disability care policies in China should consider demographic health disparities and prioritize lifelong health protection.

Keywords: Disability Trajectory, Activity of Daily Living, Cognitive Ability, Joint Identification

摘要： 女性老年人是失能的高风险群体。基于1998~2018年中国老年健康影响因素跟踪调查(CLHLS)数据，采用组基轨迹模型及其拓展模型，识别了中国女性老年人的日常行为能力轨迹与认知感知能力轨迹，并在此基础上比较了失能轨迹及其影响因素的城乡与队列差异。研究发现，中国女性老年人日常行为能力轨迹呈现出终身稳定型、晚年风险型、终身风险型3种类型；认知感知能力轨迹分为低起点失智风险型与高起点失智风险型两类；联合识别结果发现，女性老年人同时面临较高的日常行为能力与认知感知能力损伤风险的概率高达0.109；社会资本、社会保障、童年逆境、健康行为等均会对女性老年人的失能轨迹产生影响。因此，中国失能照护政策的发展既要重视人口健康的结构性差异，又要注重全生命周期的健康保护。

关键词: 失能轨迹, 日常行为能力, 认知感知能力, 联合识别