Abstract
Aging involves decline in a range of functional abilities and phenotypes, many of which are also associated with socioeconomic status (SES). Here we assessed whether lower SES is a determinant of the rate of decline over 8 y in six domains-physical capability, sensory function, physiological function, cognitive performance, emotional well-being, and social function-in a sample of 5,018 men and women aged 64.44 (SD 8.49) y on average at baseline. Wealth was used as the marker of SES, and all analyses controlled for age, gender, ethnicity, educational attainment, and long-term health conditions. Lower SES was associated with greater adverse changes in physical capability (grip strength, gait speed, and physical activity), sensory function (sight impairment), physiological function (plasma fibrinogen concentration and lung function), cognitive performance (memory, executive function, and processing speed), emotional well-being (enjoyment of life and depressive symptoms), and social function (organizational membership, number of close friends, volunteering, and cultural engagement). Effects were maintained when controlling statistically for other factors such as smoking, marital/partnership status, and self-rated health and were also present when analyses were limited to participants aged ≤75 y. We conclude that lower SES is related to accelerated aging across a broad range of functional abilities and phenotypes independently of the presence of health conditions and that social circumstances impinge on multiple aspects of aging.
Highlights
Aging involves decline in a range of functional abilities and phenotypes, many of which are associated with socioeconomic status (SES)
This study demonstrates that lower SES is related to accelerated decline over 6 to 8 y in 16 outcomes from physical, sensory, physiological, cognitive, emotional, and social domains, independently of diagnosed health conditions, self-rated health, education, and other factors
Our results indicate that lower SES is related to acceleration of a broad range of age-related impairments independently of diagnosed health conditions or self-rated health
Summary
Aging involves decline in a range of functional abilities and phenotypes, many of which are associated with socioeconomic status (SES). Socioeconomic status (SES) is a major determinant of health, with people of lower SES being at increased risk of premature mortality; the development of serious conditions such as coronary heart disease, diabetes, and depression; and other health outcomes at older ages including disability and dementia [1,2,3,4,5] These associations are underpinned by biological processes such as chronic allostatic load and sustained inflammation and by lifestyle factors including smoking and sedentary behavior [6,7,8,9]. A range of SES markers has been related to health at older ages, including indicators of childhood SES, education, occupational status, income, wealth, and area-based measures of deprivation It is less clear whether SES is a factor in aging processes independently of the development of diagnosed illnesses. We indexed SES using wealth, controlling statistically for educational attainment, since accumulation of wealth appears to be a more robust indicator of socioeconomic resources than occupational status or income at older ages [27, 28]
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