Adult Social Class Research Articles

Does moderate to vigorous physical activity mediate the association between depression and physical function in midlife: Evidence from two British birth cohort studies

BackgroundMental health and physical health are intrinsically linked, yet the mechanisms are not well understood. We investigated whether moderate-vigorous physical activity (MVPA) mediated the association between depression and physical function (PF) in midlife. MethodsIndividuals from two UK birth cohorts born within one week in 1958 (n = 7278) and 1970 (n = 6097) with data on depression (ages 33/34; Malaise Inventory), MVPA (age 42; self-reported) and PF (ages 50/56; Short Form-36 subscale). Covariates included sex, childhood and adulthood social class, maternal mental health, childhood mood, alcohol consumption, smoking habits, sleep, marital status, BMI and long-standing illness/disability. Linear or multinomial logistic regression models examined associations between depression, MVPA and PF. We used a parametric g-computation mediation analysis approach to estimate percent differences in PF. ResultsDepression was associated with less frequent MVPA and poorer PF. Lower MVPA was associated with worse PF. The direct effect – randomised analogue not operating via MVPA – of depression on PF was −18.8 % (95%CI:--25.8,-11.8) and −15.8 % (20.6,-11.0) in the 1958 and 1970 cohorts, respectively. The indirect effect – operating via MVPA – was −0.5 % (−1.0,-0.03) and −0.2 % (−0.6, 0.3), resulting in a total proportion mediated of 3.1 % (0.1, 6.0) and 0.9 % (−1.6, 3.4). LimitationsMVPA was self-reported. Intermediate confounders and mediators were measured at the same age, however associations did not change in sensitivity analysis considering age 46 MVPA (1958 cohort). ConclusionsAlthough higher MVPA was protective against poor PF, there was only minor evidence that it mediated the association between depression and PF. Further investigation into other potential mediators of pathways from mental to physical health is needed.

Examination of Early Childhood Temperament of Shyness and Social Avoidance and Associations With Cardiometabolic Health in Young Adulthood

A child temperament characterized by shyness and avoidance of social interactions is associated with poor peer relationships and emotional problems, yet its long-term associations with adult cardiometabolic health are largely unknown. To examine whether a childhood temperament characterized by shyness and avoidance of social interactions is associated with poor cardiometabolic health. This cohort study included participants who were recruited at birth between April 1991 to December 1992 as part of a prospective longitudinal cohort, the Avon Longitudinal Study of Parents and Children. Follow-up assessments of health behaviors and cardiometabolic health extended into young adulthood (age 24 years). Data analysis was conducted between April and October 2021. Parent reports of temperament across ages 3 to 6 years were used to derive childhood temperament profiles in a longitudinal clustering analysis. Accelerometry measures of adolescent moderate to vigorous physical activity (MVPA) from ages 11 to 15 years and adult social occupation class were examined as mediators using path analyses. At age 24 years, 9 cardiometabolic outcomes were measured through anthropometrics and fasting blood samples: triglyceride levels, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels, glycated hemoglobin levels, insulin levels, systolic and diastolic blood pressure, body mass index, and C-reactive protein (CRP) levels. Of the 9491 participants included in the analyses, 4908 (51.7%) were male, and 8668 of 9027 (96.0%) were White. Four childhood temperament profiles were identified: (1) introverted (2810 [29.6%]), (2) extraverted (2527 [26.6%]), (3) conflicted-shy (2335 [24.6%]), and (4) avoidant-shy (1819 [19.2%]). Lower childhood socioeconomic status was a precursor associated with the development of an avoidant-shy temperament (eg, introvert vs avoidant-shy: odds ratio, 1.13; 95% CI, 1.04-1.23). Path analyses showed that avoidant-shy children spent less time in MVPA in adolescence compared with all other temperament profiles (eg, introvert vs avoidant-shy: β = 0.10; b = 0.25; 95% CI, 0.14-0.35; P < .001), which in turn was associated with a cluster of cardiometabolic indices at age 24 years, including lower HDL cholesterol levels (β = 0.07; b = 0.95; 95% CI, 0.12-1.78; P = .03) and higher LDL cholesterol levels (β = -0.07; b = -1.69; 95% CI = -3.32 to -0.06; P = .04), insulin levels (β = -0.10; b = -0.57; 95% CI, -1.04 to -0.10; P = .02), diastolic blood pressure (β = -0.09; b = -0.59; 95% CI, -0.97 to -0.21; P = .002), and body mass index (β = -0.07; b = -0.32; 95% CI, -0.56 to -0.07; P = .01). Additionally, children classified as avoidant-shy attained lower social occupation classes at age 24 years, which was concurrently associated with higher BMI (β = 0.06; b = 0.21; 95% CI, 0.08-0.35; P = .002). Notably, these results were adjusted for a range of early developmental precursors and confounders, suggesting an independent association of temperament. In this cohort study, less engagement in physical activity across adolescence seemed to be a developmental mechanism connecting an avoidant-shy childhood temperament and greater cardiometabolic risks over the life course. Future studies should examine the efficacy of physical activity and social skill programs that specially target the needs of different children to thereby reduce cardiometabolic risks.

Socioeconomic inequalities in prevalence and development of multimorbidity across adulthood: A longitudinal analysis of the MRC 1946 National Survey of Health and Development in the UK.

BackgroundWe aimed to estimate multimorbidity trajectories and quantify socioeconomic inequalities based on childhood and adulthood socioeconomic position (SEP) in the risks and rates of multimorbidity accumulation across adulthood.Methods and findingsParticipants from the UK 1946 National Survey of Health and Development (NSHD) birth cohort study who attended the age 36 years assessment in 1982 and any one of the follow-up assessments at ages 43, 53, 63, and 69 years (N = 3,723, 51% males). Information on 18 health conditions was based on a combination of self-report, biomarkers, health records, and prescribed medications. We estimated multimorbidity trajectories and delineated socioeconomic inequalities (based on childhood and adulthood social class and highest education) in multimorbidity at each age and in longitudinal trajectories.Multimorbidity increased with age (0.7 conditions at 36 years to 3.7 at 69 years). Multimorbidity accumulation was nonlinear, accelerating with age at the rate of 0.08 conditions/year (95% CI 0.07 to 0.09, p < 0.001) at 36 to 43 years to 0.19 conditions/year (95% CI 0.18 to 0.20, p < 0.001) at 63 to 69 years. At all ages, the most socioeconomically disadvantaged had 1.2 to 1.4 times greater number of conditions on average compared to the most advantaged. The most disadvantaged by each socioeconomic indicator experienced an additional 0.39 conditions (childhood social class), 0.83 (adult social class), and 1.08 conditions (adult education) at age 69 years, independent of all other socioeconomic indicators. Adverse adulthood SEP was associated with more rapid accumulation of multimorbidity, resulting in 0.49 excess conditions in partly/unskilled compared to professional/intermediate individuals between 63 and 69 years. Disadvantaged childhood social class, independently of adulthood SEP, was associated with accelerated multimorbidity trajectories from age 53 years onwards.Study limitations include that the NSHD cohort is composed of individuals of white European heritage only, and findings may not be generalizable to the non-white British population of the same generation and did not account for other important dimensions of SEP such as income and wealth.ConclusionsIn this study, we found that socioeconomically disadvantaged individuals have earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood SEP.

Socioeconomic inequalities in co-morbidity of overweight, obesity and mental ill-health from adolescence to mid-adulthood in two national birth cohort studies.

AimTo examine socioeconomic inequalities in comorbidity risk for overweight (including obesity) and mental ill-health in two national cohorts. We investigated independent effects of childhood and adulthood socioeconomic disadvantage on comorbidity from childhood to mid-adulthood, and differences by sex and cohort.MethodsData were from 1958 National Child Development Study (NCDS58) and 1970 British Cohort Study (BCS70) [total N=30,868, 51% males] assessed at ages 10, 16, 23/26, 34 and 42 years. Socioeconomic indicators included childhood and adulthood social class and educational level. Risk for i. having healthy BMI and mental ill-health, ii. overweight and good mental health, and iii. overweight and mental ill-health was analysed using multinomial logistic regression.FindingsSocioeconomic disadvantage was consistently associated with greater risk for overweight-mental ill-health comorbidity at all ages (RRR 1.43, 2.04, 2.38, 1.64 and 1.71 at ages 10, 16, 23, 34 and 42 respectively for unskilled/skilled vs. professional/managerial class). The observed inequalities in co-morbidity were greater than those observed for either condition alone (overweight; RRR 1.39 and 1.25, mental ill-health; 1.36 and 1.22 at ages 16 and 42 respectively, for unskilled/skilled vs. professional/managerial class). In adulthood, both childhood and adulthood socioeconomic disadvantage were independently associated with comorbid overweight-mental ill-health, with a clear inverse gradient between educational level and risk for comorbidity. For instance, for the no education group (compared to university education) the RRR is 6.11 (95% CI 4.31-8.65) at age 34 and 4.42 (3.28-5.96) at age 42. There were no differences observed in the extent of inequalities by sex and differences between cohorts were limited.InterpretationWhile socioeconomic disadvantage in childhood and adulthood are consistently and independently associated with greater risk for mental ill-health and being overweight separately, these associations are even larger for their comorbidity across the lifecourse. These findings are significant given the increasing global prevalence of obesity and mental ill-health, and their implications for lifelong health and mortality.FundingThis research was supported by grants from the Wellcome Trust (ISSF3/ H17RCO/NG1) and Medical Research Council (MRC) [MC_UU_00019/3].

Life course socioeconomic position and DNA methylation age acceleration in mid-life

BackgroundAgeing biomarkers can help us better understand how well-established socioeconomic position (SEP) disparities in ageing occur. A promising new set of DNAm methylation (DNAm)-based ageing biomarkers indicate through their age...

Apolipoprotein E e4 allele status and later-life depression in the Lothian Birth Cohort 1936.

Previous results have been mixed regarding the role of the apolipoprotein E e4 (APOE e4) allele in later-life depression: some studies note that carriers experience greater symptoms and increased risk while others find no such association. However, there are few prospective, population-based studies of the APOE e4-depression association and fewer that examine depressive symptom trajectory and depression risk longitudinally. We examined the association between APOE e4 allele status and longitudinal change in depressive symptoms and depression risk in later-life, over a 12-year follow-up period. We used data from 690 participants of the Lothian Birth Cohort 1936 who took part in the Scottish Mental Survey 1947 (aged 11) and were followed-up in later-life over five waves from 2004 to 2019 (aged 70-82). We used APOE e4 allele status to predict longitudinal change in depressive symptom scores and risk of depression (defined by a symptom score threshold or use of depression-related medication). Models were adjusted for sex, childhood cognitive ability, childhood social class, education, adult social class, smoking status and functional limitations at baseline. Depressive symptom scores increased with age. Once adjusted for covariates, APOE e4 allele status did not significantly predict symptom score trajectories or depression risk. Greater functional limitations at baseline significantly predicted poorer symptom score trajectories and increased depression risk (defined by medications). APOE e4 allele status did not significantly moderate the contribution of sex, education or functional limitations. There was no evidence that APOE e4 carriers experience an increased risk for later-life depression.

Exposure to multiple childhood social risk factors and adult body mass index trajectories from ages 20 to 64 years.

While childhood social risk factors appear to be associated with adult obesity, it is unclear whether exposure to multiple childhood social risk factors is associated with accelerated weight gain during adulthood. We used the Medical Research Council National Survey of Health and Development, a British population-based birth cohort study of participants born in 1946, height and weight were measured by nurses at ages 36, 43, 53 and 60-64 and self-reported at 20 and 26 years. The 9 childhood socioeconomic risk factors and 8 binary childhood psychosocial risk factors were measured, with 13 prospectively measured at age 4 years (or at 7 or 11 years if missing) and 3 were recalled when participants were age 43. Multilevel modelling was used to examine the association between the number of childhood social risk factors and changes in body mass index (BMI) with age. Increasing exposure to a higher number of childhood socioeconomic risk factors was associated with higher mean BMI across adulthood for both sexes and with a faster increase in BMI from 20 to 64 years, among women but not men. Associations remained after adjustment for adult social class. There was no evidence of an association between exposure to childhood psychosocial risk factors and mean BMI in either sex at any age. Strategies for the prevention and management of weight gain across adulthood may need to tailor interventions in consideration of past exposure to multiple socioeconomic disadvantages experienced during childhood.

The association between secondary care multimorbidity in mid-life and premature mortality

Abstract Background Multimorbidity (MM) is the co-existence of two or more health conditions. Whilst its prevalence is higher in older adults, in absolute numbers there are more multimorbid young people. Recently, the trends for increasing life expectancy observed in high income countries have stalled or reversed. The relationship between MM and premature mortality requires exploration. We assessed the prevalence of secondary care MM in mid-life and its association with premature mortality in the Scottish Aberdeen Children of the 1950s (ACONF) cohort. Methods Prospective cohort study. ACONF members were linked to electronic hospital records and mortality records. Secondary care MM was assessed using hospital records in 2001 when participants were aged 45-51 years. The association between MM and mortality over 15 years (to age 60-66 years) was assessed using Cox proportional hazards regression. There was adjustment for key covariates: age, gender, social class at birth, childhood intelligence, educational attainment, alcohol, smoking, body mass index and adult social class. Results Of 9,625 participants (51% male), 3% had MM. Higher childhood intelligence and adult social class were associated with reduced MM. In relation to the reference group (no MM), those with MM had a mortality hazard ratio of 4.5 (95% CI 3.4-6.0) over 15 years. The association remained when adjusted for the covariates (2.5 [95% CI 1.5-4.0]). Conclusions Secondary care MM prevalence was 3% in mid-life and associated with premature mortality. Younger adults with MM are an important group at risk of premature mortality which should be the focus of public health action. This includes reducing the impact of social inequality and reconfiguring secondary care services to offer comprehensive management of younger multimorbid adults. Key messages Multimorbidity in mid-life is associated with premature mortality and may be an important influence on reducing life expectancy trends. Much focus is upon multimorbidity in older adults, however younger adults with multimorbidity are at risk of premature mortality, requiring public health action.

The association between psychological distress in mid-life and hospital-based multimorbidity

Abstract Background Mental ill-health is common with significant impact on individuals and services. Using healthcare records to identify poor mental health missed individuals who do not seek healthcare treatment. A screening questionnaire (General Health Questionnaire (GHQ)) can detect psychological distress. However, before considering implementing such a screening tool, we need to understand if it detects those at high risk of experiencing poorer outcomes. Hospital-based multimorbidity is a rising healthcare challenge. The aim was to assess the prevalence of psychological distress in mid-life and its influence on hospital-based multimorbidity by older age in the Aberdeen Children of the 1950s (ACONF) cohort. Methods Prospective cohort study using ACONF. GHQ-4 was measured in mid-life from questionnaire. Multimorbidity (2 or more co-existing conditions) was measured using linked hospital records in older age (15 years after the questionnaire). The relationship between psychological distress (GHQ-4 score of 1 or more) and multimorbidity was assessed using logistic regression with adjustment for key life-course variables. Results Of 5,839 individuals (48% male, mean age 48), psychological distress prevalence was 20% and was associated with being female, lower childhood cognition, lower educational attainment, lower adult social class, unemployment, higher adult body mass index, smoking and alcohol misuse. In comparison to the asymptomatic reference group, the odds ratio for multimorbidity in older age in those with psychological distress was 2.2 (95% CI 1.8-2.7) in the unadjusted model. In the adjusted model this was 1.4 (95% CI 1.1-1.8). Conclusions 1 in 5 individuals in the general population in mid-life had psychological distress. This was associated with hospital-based multimorbidity by older age. Intervening early could reduce costs to both individuals and healthcare services. The next step is research of the cost-effectiveness of population screening for psychological distress. Key messages Psychological distress in mid-life is associated with hospital-based multimorbidity by older age. Screening for psychological distress early in life should be explored as an intervention to reduce costs to individuals and healthcare services.

Life-course social class is associated with later-life diabetes prevalence in women: evidence from the Irish Longitudinal Study on Ageing

This study aimed to investigate the independent and synergistic effects of childhood and adult social class, as well as the effect of social mobility, on type 2 diabetes (T2D) risk in later life. Cross-sectional data from The Irish Longitudinal Study of Ageing (TILDA) (n = 4,998), a nationally representative probability sample of adults aged 50 and older, were analysed. Prevalent diabetes was defined using subjective (self-reported doctor’s diagnosis) and objective data (medications usage and glycated haemoglobin testing). Social class was classified as a three-level variable based on fathers’ occupation in childhood and respondents’ primary occupation in adulthood. A five-level social mobility variable was created from cross-classification of childhood and adulthood social class. Logistic regression was employed to assess the relationship between social class variables and T2D. Mean (SD) age of the sample was 63.8y (9.9) and 46.4% were male. Incidence of T2D was 11.6% of men and 7.7% of women. Some 57.4% of the sample were classified as Manual social class in childhood. Compared to those in Professional/Managerial occupations, belonging to the Manual social class in childhood was associated with an increased risk of T2D in men (Odds Ratio (OR): 1.36, 95% CI: 0.88, 2.10) and women (OR: 2.16, 95% CI: 1.21, 3.85). This association was attenuated in women when controlled for adulthood social class (OR: 1.84, 95% CI: 1.00–3.37), suggesting that the effect of childhood social class may be modified by improving social circumstance over the life course.

Association Between Lifetime Affective Symptoms and Premature Mortality

Associations between affective symptoms and mortality have been evaluated, but studies have not examined timing or cumulative exposure to affective symptoms over the life course. To examine how lifetime accumulation and timing of affective symptoms are associated with mortality and identify potential explanatory factors. Data were obtained from the MRC National Survey of Health and Development (1946 British birth cohort), a socially stratified, population-based sample originally consisting of 5362 singleton births in England, Wales, and Scotland during March 1946. The cohort has been followed up 24 times, most recently in 2014-2015. Eligible participants included those flagged for mortality with affective symptom data available at a minimum of 3 time points (n = 3001). Data analysis was conducted from July 2016 to January 2019. Affective symptoms were assessed at ages 13 to 15 years (teacher-rated questionnaire), 36 years (Present State Examination clinical semistructured interview), 43 years (Psychiatric Symptom Frequency questionnaire), and 53 years (General Health Questionnaire-28). Case-level affective symptoms were determined by those scoring in the top 16th percentile (ie, suggestive of a clinical diagnosis). Mortality data were obtained from the UK National Health Service Central Register from age 53 to 68 years. Of 3001 study members (1509 [50.3%] female, 1492 [49.7%] male), 235 individuals (7.8%) died over a 15-year follow-up. After adjustment for sex, those who experienced case-level affective symptoms 1, 2, and 3 to 4 times had 76%, 87%, and 134% higher rates of premature mortality, respectively, compared with those who never experienced case-level symptoms. Case-level symptoms in adolescence only (ages 13-15 years) were associated with a 94% increased rate of mortality, which was unexplained after full adjustment for covariates (hazard ratio, 1.73; 95% CI, 1.10-2.72). Associations between participants with case-level symptoms multiple (2-4) times and mortality were predominately explained by adult health indicators and behaviors. For example, associations for those with case-level symptoms 3 to 4 times were most strongly attenuated by number of health conditions (32.1%), anxiolytic use (28.4%), lung function (24.6%), physical activity (23.9%), smoking (24.6%), antidepressant use (20.1%), diet (16.4%), pulse rate (12.7%), and adult social class (11.2%). Lifetime accumulation of affective symptoms may be associated with an increased rate of mortality, with explanatory pathways dependent on the duration and timing of symptoms. Future research into causal pathways and potential points of intervention should consider affective symptom history.

Exploring the role of early-life circumstances, abilities and achievements on well-being at age 50 years: evidence from the 1958 British birth cohort study

ObjectivesWe aim to examine the relative contributions of pathways from middle childhood/adolescence to mid-life well-being, health and cognition, in the context of family socio-economic status (SES) at birth, educational achievement...

Why is parental lifespan linked to children's chances of reaching a high age? A transgenerational hypothesis

PurposeTransgenerational determinants of longevity are poorly understood. We used data from four linked generations (G0, G1, G2 and G3) of the Uppsala Birth Cohort Multigeneration Study to address this issue. MethodsMortality in G1 (N = 9565) was followed from 1961–2015 and analysed in relation to tertiles of their parents’ (G0) age-at-death using Cox regression. Parental social class and marital status were adjusted for in the analyses, as was G1’s birth order and adult social class. For an almost entirely deceased segment of G1 (n = 1149), born 1915–1917, we compared exact age-at-death with G0 parents’ age-at-death. Finally, we explored ‘resilience’ as a potentially important mechanism for intergenerational transmission of longevity, using conscript information from psychological interviews of G2 and G3 men. ResultsG0 men’s and women’s ages-at-death were independently associated with G1 midlife and old age mortality. This association was robust and minimally reduced when G0 and G1 social class were adjusted for. We observed an increased lifespan in all social groups. Median difference in age-at-death for sons compared to fathers was + 3.9 years, and + 6.9 years for daughters compared to mothers.Parents’ and maternal grandmother’s longevity were associated with resilience in subsequent generations. Resilience scores of G2 men were also associated with those of their G3 sons and with their own mortality in midlife. ConclusionsThe chance of reaching a high age is transmitted from parents to children in a modest, but robust way. Longevity inheritance is paralleled by the inheritance of individual resilience. Individual resilience, we propose, develops in the first part of life as a response to adversity and early experience in general. This gives rise to a transgenerational pathway, distinct from social class trajectories. A theory of longevity inheritance should bring together previous thinking around general susceptibility, frailty and resilience with new insights from epigenetics and social epidemiology.

Adult literacy provision and social class: Australian contexts

Adult literacy provision began in Australia during a radical education era in the 1970s, and yet in recent decades, social class as a construct has been largely absent in the academic literature on adult literacy. We argue however that social class is essential to understanding adult literacy provision and furthermore that working class people have not been well served by this provision since the time literacy assumed enhanced status as human capital from the 1990s. We make our case through asking and responding to questions relating to the social class backgrounds of students and their teachers, how people are assessed to need literacy, what is taught, who undertakes research and who influences adult literacy policy. At the macro, structural level of analysis, we discuss the influence on adult literacy provision of the ruling class agendas of international agencies (i.e. the OECD) and national agencies representing capital. At the meso level, we discuss how the main adult literacy provider, technical and further education (TAFE) has failed to meet the adult literacy needs of working class students due to neo-liberal reforms. And at the micro, classroom level, we discuss some implications of class disparities between adult literacy teachers and their students.

Relationship between mediation analysis and the structured life course approach.

Many questions in life course epidemiology involve mediation and/or interaction because of the long latency period between exposures and outcomes. In this paper, we explore how mediation analysis (based on counterfactual theory and implemented using conventional regression approaches) links with a structured approach to selecting life course hypotheses. Using theory and simulated data, we show how the alternative life course hypotheses assessed in the structured life course approach correspond to different combinations of mediation and interaction parameters. For example, an early life critical period model corresponds to a direct effect of the early life exposure, but no indirect effect via the mediator and no interaction between the early life exposure and the mediator. We also compare these methods using an illustrative real-data example using data on parental occupational social class (early life exposure), own adult occupational social class (mediator) and physical capability (outcome).

Adulthood Social Class and Union Interest: A First Test of a Theoretical Model

ABSTRACTA serial mediation model of union interest was tested. Based on theoretical notes provided by Mellor and Golay (in press), adulthood social class was positioned as a predictor of willingness to join a labor union, with success/failure attributions at work and willingness to share work goals positioned as intervening variables. Data from U.S. nonunion employees (N = 560) suggested full mediation after effects were adjusted for childhood social class. In sequence, adulthood social class predicted success/failure attributions at work, success/failure attributions at work predicted willingness to share work goals, and willingness to share work goals predicted willingness to join. Implications for socioeconomic status (SES) research and union expansion are discussed.

Life course socioeconomic status and the decline in information processing speed in late life

Low socio-economic status is a recognised composite measure made up of income, education and occupational social class, which is a risk factor for poor physical and mental health and late life dementia. Here, we distinguish between components of childhood socioeconomic status to explore their separate influences of childhood and adult occupational social class (OSC), childhood mental ability and education on late life cognitive ability and change trajectories. Cognitive data were collected longitudinally from a sub-sample (N = 478) of the Aberdeen 1936 birth cohort tested on up to 5 occasions between ages 63 and 78 years. Age 11 mental ability scores were available for all participants. We used longitudinal multi-level linear modelling to explore models of cognitive change that distinguished between the possible influences of parental occupation, participants' own occupation as adults, duration of formal education, childhood mental ability and the participants' own occupation. We showed that parental occupation and the participants' own occupation are independently associated with cognition in late life, but do not influence the trajectory of cognitive change. However, when models include childhood mental ability and education the influence of parental and participant occupation is no longer significant. The association in these data between parental occupation and late life cognitive variation is accounted for by childhood mental ability and duration of formal education. However, we cannot exclude the possibility that parental occupation in early life influences early life mental ability and duration of education. The trajectory of change with age is similar across all models, with none of the life course factors (education, parental and participant occupational social class and childhood ability) significantly co-varying with the trajectory of cognitive variation.

Adolescent Self-Organization and Adult Smoking and Drinking over Fifty Years of Follow-Up: The British 1946 Birth Cohort.

Variations in markers of adolescent self-organization predict a range of economic and health-related outcomes in general population studies. Using a population-based birth cohort study we investigated associations between adolescent self-organization and two common factors over adulthood influencing health, smoking and alcohol consumption. The MRC National Survey of Health and Development (the British 1946 birth cohort) was used to test associations between a dimensional measure of adolescent self-organization derived from teacher ratings, and summary longitudinal measures of smoking and alcohol consumption over the ensuing five decades. Multinomial regression models were adjusted for sex, adolescent emotional and conduct problems, occupational social class of origin, childhood cognition, educational attainment and adult occupational social class. With all covariates adjusted, higher adolescent self-organization was associated with fewer smoking pack years, although not with quitting; there was no association with alcohol consumption across adulthood (none or heavy compared with light to moderate). Adolescent self-organization appears to be protective against smoking, but not against heavy alcohol consumption. Interpretation of this differential effect should be embedded in an understanding of the social and sociodemographic context in which these health behaviours occur over time.

Bullying victimization in childhood predicts inflammation and obesity at mid-life: a five-decade birth cohort study.

We aimed to test whether childhood bullying victimization increases risk for age-related disease at mid-life using biological markers including inflammation and adiposity, independent of other childhood risk factors and key adult variables. The present study was a 50-year prospective longitudinal birth cohort study of all births in Britain in 1 week in 1958. Exposure to bullying was assessed prospectively when participants were aged 7 and 11 years (27.7% occasionally bullied; 14.6% frequently bullied). Blood inflammation biomarkers [C-reactive protein (CRP) and fibrinogen] and adiposity [body mass index (BMI) and waist:hip ratio] were measured at age 45 years. Participants who had been frequently bullied in childhood showed increased levels of CRP at mid-life [β = 0.07, 95% confidence interval (CI) 0.04-0.10] and higher risk for clinically relevant inflammation cut-off [CRP > 3 mg/l: 20.4% v. 15.9%, odds ratio (OR) = 1.35, 95% CI 1.12-1.64]. Women who were bullied in childhood had higher BMI than non-bullied participants and were at increased risk of being obese (BMI ≥ 30 kg/m2: occasionally bullied: 26.0% v. 19.4%, OR = 1.45, 95% CI 1.18-1.77; frequently bullied: 26.2% v. 19.4%, OR = 1.41, 95% CI 1.09-1.83). Findings remained significant when controlling for childhood risk factors (e.g. parental social class; participants' BMI and psychopathology in childhood) and key adult variables (e.g. adult social class, smoking, diet and exercise). Bullied children show increases in risk factors for age-related disease in middle adulthood, independent of co-occurring childhood and adult risks. Given the high prevalence of bullying victimization in childhood, tackling this form of psychosocial stress early in life has the potential of reducing risk for age-related disease and its associated burden.

Diet quality in older age: the influence of childhood and adult socio-economic circumstances.

Socio-economic gradients in diet quality are well established. However, the influence of material socio-economic conditions particularly in childhood, and the use of multiple disaggregated socio-economic measures on diet quality have been little studied in the elderly. In the present study, we examined childhood and adult socio-economic measures, and social relationships, as determinants of diet quality cross-sectionally in 4252 older British men (aged 60-79 years). A FFQ provided data on daily fruit and vegetable consumption and the Elderly Dietary Index (EDI), with higher scores indicating better diet quality. Adult and childhood socio-economic measures included occupation/father's occupation, education and household amenities, which combined to create composite scores. Social relationships included social contact, living arrangements and marital status. Both childhood and adult socio-economic factors were independently associated with diet quality. Compared with non-manual social class, men of childhood manual social class were less likely to consume fruit and vegetables daily (OR 0.80, 95% CI 0.66, 0.97), as were men of adult manual social class (OR 0.65, 95% CI 0.54, 0.79), and less likely to be in the top EDI quartile (OR 0.73, 95% CI 0.61, 0.88), similar to men of adult manual social class (OR 0.66, 95 % CI 0.55, 0.79). Diet quality decreased with increasing adverse adult socio-economic scores; however, the association with adverse childhood socio-economic scores diminished with adult social class adjustment. A combined adverse childhood and adulthood socio-economic score was associated with poor diet quality. Diet quality was most favourable in married men and those not living alone, but was not associated with social contact. Diet quality in older men is influenced by childhood and adulthood socio-economic factors, marital status and living arrangements.