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

Journal of Epidemiology and Community Health - Tập 73 Số 8 - Trang 703-711 - 2019
Boris Cheval1, Dan Orsholits2, Stefan Sieber2, Silvia Stringhini3, Delphine S. Courvoisier4,2, Matthias Kliegel5,2, Matthieu P. Boisgontier6, Stéphane Cullati4,2
1Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva 1205, Switzerland
2Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Switzerland
3Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland
4Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
5Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
6Physical Therapy, UBC Hospital, Vancouver, British Columbia, Canada

Tóm tắt

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.

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