Prior incarceration and functional limitation trajectories in older adults

Introduction Functional limitations are a key indicator of ageing, associated with quality of life, independence and the need for caregiving and long-term support. Research shows that formerly incarcerated older adults have more functional limitations than those who have never been incarcerated, yet there is a lack of research on prior incarceration and changes in functional limitations over time. Methods Data come from 8377 adults aged ≥55 who participated in the Health and Retirement Study and were followed biennially from 2012 to 2022. Self-reported functional limitations were measured at each wave as a count of nine functional tasks. Group-based trajectory modelling identified subgroups characterised by patterns of functional limitations over time. Multinomial logistic regression was used to estimate the association between self-reported prior incarceration and trajectory group membership. Results We identified five distinct trajectories of functional limitations: low (23.8%), low-increasing (26.8%), moderate-increasing (24.2%), high-increasing (16.6%), and persistent-high (8.5%). Relative to the consistently low group, formerly incarcerated individuals (v. never incarcerated individuals) had a higher relative risk of membership in the moderate-increasing group (RRR=1.588, 95% CI 1.096 to 2.302), the high-increasing group (RRR=2.122, 95% CI 1.450 to 3.107), and the persistent-high group (RRR=2.181, 95% CI 1.207 to 3.940) after adjusting for covariates. Conclusions These findings suggest that incarceration may be an important life-course marker of elevated risk for late-life functional limitations and highlight the need for targeted clinical and policy interventions to support functional health among formerly incarcerated older adults.