Abstract
BackgroundThis study examines the associations between lifecourse adversity and physical performance in old age in different societies of North and South America and Europe.MethodsWe used data from the baseline survey of the International Study of Mobility in Aging, conducted in: Kingston (Canada), Saint-Hyacinthe (Canada), Natal (Brazil), Manizales (Colombia) and Tirana (Albania). The study population was composed of community dwelling people between 65 and 74 years of age, recruiting 200 men and 200 women at each site. Physical Performance was assessed with the Short Physical Performance Battery (SPPB). Economic and social adversity was estimated from childhood adverse events, low education, semi-skilled occupations during adulthood and living alone and insufficient income in old age.ResultsA total of 1995 people were assessed. Low physical performance was associated with childhood social and economic adversity, semi-skilled occupations, living alone and insufficient income. Physical performance was lower in participants living in Colombia, Brazil and Albania than in Canada counterparts, despite adjustment for lifecourse adversity, age and sex.ConclusionsWe show evidence of the early origins of social and economic inequalities in physical performance during old age in distinct populations and for the independent and cumulative disadvantage of low socioeconomic status during adulthood and poverty and living alone in later life.
Highlights
Knowledge of lifecourse conditions and aging across diverse societies is needed to promote healthy aging [1,2,3]
Birnie et al reported that the associations of childhood socioeconomic position (SEP) with physical performance were maintained after adjustment by adult SEP, suggesting that the accumulation of adverse exposures over a lifetime may be a better model of the associations than one which considers only adult factors and concluded that the associations of childhood socioeconomic position with physical capability vary by study context including geographical location and birth period, whereby SEP in early life may play a more important role in some contexts than others [5]
We propose that early childhood social disadvantage, including exposure to violence and conflict, is an independent risk factor for poor physical function in old age
Summary
Knowledge of lifecourse conditions and aging across diverse societies is needed to promote healthy aging [1,2,3]. While considerable research describes the relationship between individual circumstances over time, and physical function in older populations [4,5,6,7,8] few of these studies include middle and lowincome countries where very different childhood and adulthood conditions may shape aging [5]. Most lifecourse studies examine ongoing effects of socioeconomic adversity [3,4,5,6,8,9,10,11,12,13]. Newer evidence shows that the strong and latent effects on chronic disease incidence of adverse events occurring in childhood arise from more than economic deprivation.
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