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Eur J Public Health. 2019 Feb 1;29(1):50-58. doi: 10.1093/eurpub/cky166.

Childhood socioeconomic circumstances and disability trajectories in older men and women: a European cohort study.

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Institute of Demography and Socioeconomics, University of Geneva, Geneva, Switzerland.
Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland.
Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland.
Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.
Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, London, UK.
Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
Department of Movement Sciences, KU Leuven, Leuven, Belgium.
Unit of Population Epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland.



We observed a lack of population-based longitudinal research examining the association of disadvantaged childhood socioeconomic circumstances (CSC) and disability [activities of daily living (ADL) and instrumental activities of daily living (IADL)] in older age, and whether socioeconomic attainments in adulthood can compensate for a poor socioeconomic start in life.


Data on 24 440 persons aged 50-96 in 14 European countries (Survey of Health, Ageing and Retirement in Europe) were used to measure the associations between CSC and limitations with ADL and with IADL, using mixed-effects logistic regression models. Models stratified by gender were adjusted for education during young adulthood, main occupation during middle age, ability to make ends meet during old age and potential confounding and control variables.


Risks of ADL and IADL limitations increased with age and were different between women and men. For women, a gradient across CSC strata was observed, showing that the more disadvantaged the CSC, the higher the risk of ADL and IADL limitations in old age, even after adjustment for adult socioeconomic indicators. For men, the association between CSC and disability was mediated by the main occupation in middle age and the ability to make ends meet at older age.


Women who grew up in socioeconomically disadvantaged households were at higher risk of disability in older age and this disadvantage was not attenuated by favourable adult socioeconomic conditions. Men were more likely to make up for a disadvantaged start in adulthood.


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