Individuals age at vastly different rates resulting in significant within-population heterogeneity in health and aging outcomes. This diversity in health and aging trajectories has rarely been investigated among low-income aging populations that have experienced substantial hardships throughout their lifecourses. Utilizing 2006–2019 data from the Malawi Longitudinal Study of Families and Health and estimating group-based trajectory models, our analyses identified three distinct lifecourse health trajectories: (1) comparatively good initial mental and physical health that persisted throughout the lifecourse (“resilient aging”), (2) relatively good initial mental and physical health that started to deteriorate during mid-adulthood (“accelerated aging”), and (3) poor initial mental and physical health that further declined over the lifecourse (“aging with persistently poor health”). For both physical and mental health, men were more likely to enjoy resilient aging than women. Predictors other than gender of trajectory membership sometimes confirmed, and sometimes contradicted, hypotheses derived from high-income country studies. Our analyses highlight the long arm of early life conditions and gender in determining aging trajectories and show that a nontrivial subpopulation is characterized by aging with persistently poor health. The study uncovers widening gaps in health outcomes between those who age with resilience and those who experience accelerated aging.

中文翻译：

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复原力、加速衰老和持续不佳的健康状况：马拉维的多样化健康轨迹

个体的衰老速度差异很大，导致健康和衰老结果存在显着的人群内异质性。这种健康和老龄化轨迹的多样性很少在低收入老龄化人口中进行调查，因为他们在整个生命过程中经历了巨大的困难。利用马拉维家庭与健康纵向研究的 2006-2019 年数据并估计基于群体的轨迹模型，我们的分析确定了三种不同的生命周期健康轨迹：（1）在整个生命过程中持续相对良好的初始心理和身体健康（“弹性衰老”） ”），（2）相对良好的初始心理和身体健康状况，在成年中期开始恶化（“加速衰老”），以及（3）较差的初始心理和身体健康状况，在整个生命过程中进一步恶化（“持续较差的衰老”）健康”）。就身心健康而言，男性比女性更有可能享受弹性衰老。除性别之外的轨迹成员预测因素有时证实、有时反驳来自高收入国家研究的假设。我们的分析强调了早期生活条件和性别在决定衰老轨迹方面的长臂，并表明一个重要的亚群体的特点是衰老且健康状况持续不佳。该研究发现，那些具有韧性的衰老者和那些经历加速衰老的人之间的健康结果差距日益扩大。