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J Gerontol B Psychol Sci Soc Sci. 2019 Oct 30. pii: gbz140. doi: 10.1093/geronb/gbz140. [Epub ahead of print]

Life-course circumstances and frailty in old age within different European welfare regimes: a longitudinal study with SHARE.

Author information

1
Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Switzerland.
2
Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland.
3
Department of Readaptation and Geriatrics, University of Geneva, Switzerland.
4
Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Switzerland.
5
Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland.
6
ZHAW, Zurich University of Applied Sciences.
7
INSERM, UMR, Toulouse, France.
8
Université Toulouse III Paul-Sabatier, UMR, Toulouse, France.
9
NOVA - Norwegian Social Research, Center for Welfare and Labor Research, Oslo, Norway.
10
International Centre for Life Course Studies in Society and Health, Department of Epidemiology and Public Health, University College London, United Kingdom.
11
Institute of Sociological Research, University of Geneva, Switzerland.

Abstract

OBJECTIVES:

This study aimed to assess whether cumulative disadvantage in childhood misfortune and adult-life socioeconomic conditions influence the risk of frailty in old age and whether welfare regimes influence these associations.

METHODS:

Data from 23358 participants aged 50 years and older included in the longitudinal SHARE survey were used. Frailty was operationalized according to Fried's phenotype as presenting either weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted mixed-effects logistic regression models were used to analyse associations of childhood misfortune and life-course socioeconomic conditions with frailty.

RESULTS:

Childhood misfortune and poor adult-life socioeconomic conditions increased the odds of (pre-)frailty at older age. With aging, differences narrowed between categories of adverse childhood experiences (driven by Scandinavian welfare regime) and adverse childhood health experiences (driven by Eastern European welfare regime), but increased between categories of occupational position (driven by Bismarckian welfare regime).

DISCUSSION:

These findings suggest that childhood misfortune is linked to frailty in old age. Such a disadvantaged start in life does not seem to be compensated by a person's life-course socioeconomic trajectory, though certain types of welfare regimes affected this relationship. Apart from main occupational position, our findings do not support the cumulative dis/advantage theory, but rather show narrowing differences.

KEYWORDS:

Childhood Disadvantage; Health Outcomes; Socioeconomic Status; Successful Aging

PMID:
31665484
DOI:
10.1093/geronb/gbz140

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