Joint trajectories of episodic memory and mobility difficulties in older adults in China and the United States: a longitudinal cohort study
- 1Department of Rehabilitation Medicine, The Second People’s Hospital of Neijiang, Neijiang, China
- 2Department of Endocrinology, Neijiang Hospital of Traditional Chinese Medicine, Neijiang, China
- 3Department of Rehabilitation Medicine, Jinniu District People’s Hospital of Chengdu, Chengdu, China
Abstract
BackgroundMemory and mobility may deteriorate together or follow different courses in later life. We examined joint trajectories and their associated factors in older Chinese and US adults.MethodsWe analyzed four waves of the China Health and Retirement Longitudinal Study (2011–2018) and the US Health and Retirement Study (2012–2018). Participants were aged ≥60 years at baseline and had at least three valid measurements of both episodic memory and self-reported mobility difficulties. Cohort-specific multivariate latent class mixed models identified joint trajectories. Multinomial logistic regression examined 13 covariates. Six classification algorithms distinguished two unfavorable trajectories from a higher-memory/low-difficulty group using stratified training/test splits. Shapley additive explanations characterized contributions to XGBoost predictions.ResultsTrajectory analyses included 4,360 Chinese and 8,407 US participants; regression analyses included 4,357 and 8,352, respectively. Four trajectories were retained in each cohort. Dual decline accounted for 12.9% and 14.9%, and memory decline with high mobility difficulty for 16.0% and 15.0%, respectively. Memory decline with low mobility difficulty occurred in 42.8% of Chinese participants, whereas decreasing self-reported mobility difficulty with memory decline occurred in 17.7% of US participants. Depressive symptoms were associated with dual decline per cohort-specific standard deviation increase: adjusted odds ratios were 1.56 (95% confidence interval 1.38–1.76) and 1.51 (1.39–1.63), respectively. Corresponding estimates for arthritis were 1.53 (1.22–1.93) and 2.40 (2.07–2.77). Across algorithms, test areas under the receiver operating characteristic curve ranged from 0.783 to 0.807 and 0.692 to 0.735 for dual decline, and 0.863 to 0.890 and 0.859 to 0.881 for high mobility difficulty. Logistic regression performed best in both US comparisons.ConclusionEpisodic memory and mobility difficulties followed both parallel and divergent courses in CHARLS and HRS. Depressive symptoms and arthritis were associated with unfavorable trajectories in both cohorts. Joint assessment characterizes distinct patterns of functional aging beyond describing either domain alone.
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BibTeX
@article{liu2026joint,
title = {{Joint trajectories of episodic memory and mobility difficulties in older adults in China and the United States: a longitudinal cohort study}},
author = {Ying Liu and Shao Yin and Yusheng Li and Tao Sun},
journal = {Frontiers in Aging Neuroscience},
year = {2026},
month = nov,
doi = {10.3389/fnagi.2026.2001920},
url = {https://doi.org/10.3389/fnagi.2026.2001920},
note = {CC BY},
}
RIS
TY - JOUR
TI - Joint trajectories of episodic memory and mobility difficulties in older adults in China and the United States: a longitudinal cohort study
AU - Ying Liu
AU - Shao Yin
AU - Yusheng Li
AU - Tao Sun
PY - 2026
DA - 2026/11/12
JO - Frontiers in Aging Neuroscience
DO - 10.3389/fnagi.2026.2001920
UR - https://doi.org/10.3389/fnagi.2026.2001920
AB - BackgroundMemory and mobility may deteriorate together or follow different courses in later life. We examined joint trajectories and their associated factors in older Chinese and US adults.MethodsWe analyzed four waves of the China Health and Retirement Longitudinal Study (2011–2018) and the US Health and Retirement Study (2012–2018). Participants were aged ≥60 years at baseline and had at least three valid measurements of both episodic memory and self-reported mobility difficulties. Cohort-specific multivariate latent class mixed models identified joint trajectories. Multinomial logistic regression examined 13 covariates. Six classification algorithms distinguished two unfavorable trajectories from a higher-memory/low-difficulty group using stratified training/test splits. Shapley additive explanations characterized contributions to XGBoost predictions.ResultsTrajectory analyses included 4,360 Chinese and 8,407 US participants; regression analyses included 4,357 and 8,352, respectively. Four trajectories were retained in each cohort. Dual decline accounted for 12.9% and 14.9%, and memory decline with high mobility difficulty for 16.0% and 15.0%, respectively. Memory decline with low mobility difficulty occurred in 42.8% of Chinese participants, whereas decreasing self-reported mobility difficulty with memory decline occurred in 17.7% of US participants. Depressive symptoms were associated with dual decline per cohort-specific standard deviation increase: adjusted odds ratios were 1.56 (95% confidence interval 1.38–1.76) and 1.51 (1.39–1.63), respectively. Corresponding estimates for arthritis were 1.53 (1.22–1.93) and 2.40 (2.07–2.77). Across algorithms, test areas under the receiver operating characteristic curve ranged from 0.783 to 0.807 and 0.692 to 0.735 for dual decline, and 0.863 to 0.890 and 0.859 to 0.881 for high mobility difficulty. Logistic regression performed best in both US comparisons.ConclusionEpisodic memory and mobility difficulties followed both parallel and divergent courses in CHARLS and HRS. Depressive symptoms and arthritis were associated with unfavorable trajectories in both cohorts. Joint assessment characterizes distinct patterns of functional aging beyond describing either domain alone.
SN - 1663-4365
ER -