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

J Epidemiol Community Health. 2019 Aug;73(8):703-711. doi: 10.1136/jech-2019-212110. Epub 2019 Apr 9.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Allostasis
  • Cognition / physiology
  • Depression / epidemiology
  • Europe / epidemiology
  • Female
  • Geriatric Assessment
  • Health Status Disparities*
  • Health Status Indicators*
  • Healthy Aging / physiology*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Muscle Strength / physiology
  • Respiratory Function Tests
  • Risk Factors
  • Social Class*
  • Surveys and Questionnaires