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J Epidemiol Community Health. 2019 Apr 9. pii: jech-2019-212110. doi: 10.1136/jech-2019-212110. [Epub ahead of print]

Early-life socioeconomic circumstances explain health differences in old age, but not their evolution over time.

Author information

1
Swiss NCCR 'LIVES - Overcoming Vulnerability: Life Course Perspectives', University of Geneva, Geneva, Switzerland boris.cheval@unige.ch.
2
Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland.
3
Swiss NCCR 'LIVES - Overcoming Vulnerability: Life Course Perspectives', University of Geneva, Geneva, Switzerland.
4
Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland.
5
Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.
6
Physical Therapy, UBC Hospital, Vancouver, British Columbia, Canada.

Abstract

BACKGROUND:

Early-life socioeconomic circumstances (SEC) are associated with health in old age. However, epidemiological evidences on the influence of these early-life risk factors on trajectories of healthy ageing are inconsistent, preventing drawing solid conclusion about their potential influence. Here, to fill this knowledge gap, we used a statistical approach adapted to estimating change over time and an outcome-wide epidemiology approach to investigate whether early-life SEC were associated with the level of and rate of decline of physical, cognitive and emotional functioning over time.

METHODS:

We used data on more than 23 000 adults in older age from the Survey of Health, Ageing and Retirement in Europe, a 12-year large-scale longitudinal study with repeated measurements of multiple health indicators of the same participants over time (2004 -2015, assessments every 2 years). Confounder-adjusted linear growth curve models were used to examine the associations of early-life SEC with the evolution of muscle strength, lung function, cognitive function, depressive symptoms and well-being over time.

RESULTS:

We consistently found an association between early-life SEC and the mean levels of all health indicators at age 63.5, with a critical role played by the cultural aspect of disadvantage. These associations were only partly explained by adult-life SEC factors. By contrast, evidences supporting an association between early-life SEC and the rate of change in health indicators were weak and inconsistent.

CONCLUSIONS:

Early-life SEC are associated with health in old age, but not with trajectories of healthy ageing. Conceptual models in life course research should consider the possibility of a limited influence of early-life SEC on healthy ageing trajectories.

KEYWORDS:

ageing trajectories; early life; health status; healthy ageing; socioeconomic factors

PMID:
30967487
DOI:
10.1136/jech-2019-212110

Conflict of interest statement

Competing interests: None declared.

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