Comparing physical and mental health across age gradients among older adults during the COVID-19 pandemic

Abstract Background While aging brings inevitable health decline, few studies have examined how social and behavioral factors shape physical and mental health trajectories in older adulthood. This study examined the prevalence and patterns of self-reported physical and mental health patterns among U.S. adults aged 60 and older, focusing on age groups differences optimal intervention timing, and modifiable predictors. Methods Using the Behavioral Risk Factor Surveillance System data from 2021–2023, we applied frequentist generalized ordered logistic and Bayesian ordinal logistic regressions to assess robustness across inferential frameworks. Results Older age was associated with progressively lower odds of reporting poor physical and mental health, with the 60–64 age group consistently reporting worse outcomes than older cohorts (65–69, 70–74, 75–79, and ≥ 80). While both domains followed similar age-related patterns, the magnitude of age associations was greater for mental health. Conclusion This study highlights “a tale of two age gradients” in older adulthood: ages 60–64 mark a critical intervention window, with elevated risks for both poor physical and mental health compared with older cohorts.