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.