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Background Components of physical frailty cluster into subtypes, but it remains unknown how these might be associated with age‐related functional declines and multimorbidities. This study aims to investigated associations of physical frailty subtypes with functional declines and multimorbidity in a 10 year longitudinal cohort survey. Methods Complementary longitudinal cohort study used group‐based multitrajectory modelling to verify whether frailty subtypes discovered in Taiwan are presented in another aging cohort, then investigated associations of these subtypes with cognitive decline and multimorbidity. Participants aged ≥50 years were recruited from the third to sixth waves (May 2002 to July 2010) of the National Institute for Longevity Sciences‐Longitudinal Study of Aging, in Japan. People with incomplete data, pre‐frail/frail status before their index wave, and those with incomplete data or who died during follow‐up, were excluded. Group‐based trajectory analysis denoted five established physical frailty criteria as time‐varying binary variables in each wave during follow‐up. Incident frailty was classified as mobility subtype (weakness/slowness), non‐mobility subtype (weight loss/exhaustion), or low physical activity subtype. General linear modelling investigated associations of these frailty subtypes with activities of daily living, digit symbol substitution test (DSST) and Charlson Comorbidity Index (CCI) at 2 year follow‐up. Results We identified four longitudinal trajectories of physical frailty, which corroborated the distinct subtypes we discovered previously. Among 940 eligible participants, 38.0% were robust, 18.4% had mobility subtype frailty, 20.7% non‐mobility subtype, and 20.1% low physical activity subtype. People with mobility subtype frailty were older than those with other frailty subtypes or robust status and had higher prevalence of hypertension, diabetes, and heart failure. In the multivariable‐adjusted general linear models, mobility‐subtype frailty was associated with a significantly lower DSST score (point estimate −2.28, P = 0.03) and higher CCI (point estimate 0.82, P < 0.01) than the other groups. Conclusions Mobility‐subtype frailty was associated with functional declines and progression of multimorbidity; the long‐term effects of physical frailty subtypes deserve further investigation.

Introduction Firearm access and associated risk behaviors (i.e., firearm storage and carriage) are established factors that increase the risk of firearm-related injuries. While extant research has demonstrated associations between singular substance use and these risks, little is known regarding the impact of polysubstance use on these outcomes. The present study aims to investigate the relationships between polysubstance use in adolescence and four specific firearm-related risks manifesting in emerging adulthood. Methods Ten years of annual data from a cohort of 1,042 adolescents initially aged 13–18 years were analyzed to identify polysubstance use trajectories and their associations with firearm-related behaviors in emerging adulthood. Using group-based multi-trajectory modeling, polysubstance use patterns from adolescence to emerging adulthood were identified. Associations between membership in these trajectory groups and four firearm-related risk factors in emerging adulthood—firearm access, improper storage of firearms and ammunition, and frequent carriage—were assessed using multivariable logistic regression. Results Five distinct polysubstance risk trajectories were identified. The highest rates of firearm access were observed among Chronic Illicit and Non-Illicit Polysubstance Users. The greatest prevalence of improper firearm storage was exhibited by Alcohol Ascenders and Chronic Non-Illicit Users . Additionally, significantly higher odds of engaging in frequent firearm carrying were found for all polysubstance use groups compared to Mild Alcohol Users, with the exception of Chronic Illicit Users. No significant associations were observed for improper ammunition storage across groups. Conclusion This study is among the first to identify specific associations between firearm-related risk behaviors and distinct polysubstance use trajectories. The findings provide novel insights for developing targeted interventions to mitigate firearm risks in polysubstance-using individuals transitioning from adolescence to young adulthood.

Medication adherence is a crucial factor for managing chronic conditions, especially in aging adults. Previous studies have identified predictors of medication adherence. However, current methods fail to capture the time-varying nature of how risk factors can influence adherence behavior. This objective of this study was to implement multitrajectory group-based models to compare a time-varying to a time-fixed approach to identifying non-adherence risk factors. The study population comprised 11,068 Medicare beneficiaries aged 65 and older taking select medications for hypertension, high blood cholesterol, and oral diabetes medications, between 2008 and 2016. Time-fixed predictors (e.g., sex, education) were examined using generalized multinomial logistic regression, while time-varying predictors were explored through multitrajectory group-based modeling. Several predisposing, enabling, and need characteristics were identified as risk factors for following at least one non-adherence trajectory. Time-varying predictors displayed an alternative representation of those risk factors, especially depression symptoms. This study highlights the dynamic nature of medication adherence predictors and the utility of multitrajectory modeling. Findings suggest that targeted interventions can be developed by addressing the key time-varying factors affecting adherence.

That formerly incarcerated black men experience poor life-course outcomes relative to other subpopulations is well established, yet our ongoing research indicates substantial racial inequality in outcomes among the formerly incarcerated. Young, black former prisoners lag behind their white counterparts in achieving traditional adulthood markers: education, employment, and residential independence. We examine explanations for these inequalities using longitudinal administrative data on a cohort of male parolees age eighteen to twenty-five. We find that early postprison experiences and social context explain some variation. Considerable racial inequality persists, however, even as we control for pre- and postprison life-course conditions, criminal justice contact, and social context. We discuss this in relation to estimates of discrimination, stigma, and social networks not observable in our data.