{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:19:40Z","timestamp":1788794380032,"version":"build-2803163510"},"reference-count":44,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2026,3,23]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data come from 8377 adults aged \u226555\u2009who 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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%\u2009CI 1.096 to 2.302), the high-increasing group (RRR=2.122, 95%\u2009CI 1.450 to 3.107), and the persistent-high group (RRR=2.181, 95%\u2009CI 1.207 to 3.940) after adjusting for covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2026-225837","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T17:20:25Z","timestamp":1775150425000},"page":"727-733","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Prior incarceration and functional limitation trajectories in older adults"],"prefix":"10.1136","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8686-9115","authenticated-orcid":false,"given":"Alexander","family":"Testa","sequence":"first","affiliation":[{"name":"Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratnasree","family":"Vaddepalli","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, The University of Texas Health Science Center at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Mijares","sequence":"additional","affiliation":[{"name":"Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaming","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6010-8457","authenticated-orcid":false,"given":"Chantal","family":"Fahmy","sequence":"additional","affiliation":[{"name":"Department of Criminology & Criminal Justice, The University of Texas at San Antonio, San Antonio, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Novisky","sequence":"additional","affiliation":[{"name":"Corrections Institute, University of Cincinnati, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Public Policy, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa","family":"Holaday","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA"},{"name":"Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-648X","authenticated-orcid":false,"given":"Jack","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA"},{"name":"Department of Psychiatry, Yale University School of Medicine, West Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"2026081002300733000_80.9.727.1","doi-asserted-by":"crossref","unstructured":"Garland D . 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