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We found that early life SES (education) was associated with trajectory affiliation at age 85, with those less educated more likely to be in the most disabled trajectory, even after adjusting for multiple confounding variables.

After adjusting for confounders education remained significant; men and women with most education being less likely to be in the most disabled trajectory (Men: OR = 0.80, 95% CI 0.65 0.98; women: OR = 0.59, 95% CI 0.42 0.83).

Men and women who had been in managerial occupations were less likely to belong to the most disabled trajectory (Men: OR = 0.33, 95% CI 0.15 0.71; women: OR = 0.33, 95% CI 0.21 0.51) and women from manual occupations were more likely to be in the most disabled (FT4) than the least disabled (FT1) trajectory (OR = 1.35, 95% CI 1.05 1.74).

Late-life socio-economic status (IMD) only impacted men, with those in the least deprived quartile of IMD being less likely to be in the most disabled trajectory (MT4) compared to the least disabled (MT1) (OR = 0.42, 95% CI 0.31 0.57).

Those with 12 or more years of education were less likely to belong to the most disabled trajectory compared to the least (Men: OR = 0.69, 95% CI 0.51 0.93; women: OR = 0.54, 95% CI 0.30 0.96) and women with the least education (0 9 years) were more likely to be in the most disabled (FT4) than the least disabled (FT1) trajectory (OR = 1.21, 95% CI 1.01 1.45).

Similar(55)

The most disabled trajectories had severe disability at age 85 progressing to profound disability by age 90.

If these trajectories remain static over the course of the next fifteen years (to 2030) and with the increases in the very old population (aged 85 and over: 47.3% for men and 38.6% for women) we will see increases in the region of 50,000 people (in the UK) who belong to the most disabled trajectories (WT3/MT3 WT3/MT4).

Moreover, although the effects of SES in mid-life (occupationally based) and late-life (area deprivation) on trajectory membership were attenuated after adjustment for potential confounders, the effect of early-life SES (education) remained, with men and women with the more education (12+ years) being significantly less likely to be in the most disabled trajectories.

Results In the last year of life, six distinct trajectories of disability were identified, from least disabled to most disabled: 95 participants (17.2%) had no disability, 61 (11.1%) had catastrophic disability, 53 (9.6%) had accelerated disability, 61 (11.1%) had progressively mild disability, 127 (23.0%) had progressively severe disability, and 155 (28.1%) had persistently severe disability.

Thus men and women with the most education remained less likely to be in the greatest, compared to the least, disabled trajectory (Men: OR = 0.80, 95% CI 0.65 0.98; women: OR = 0.59, 95% CI 0.42 0.83).

Most disabled people want work.

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