Life Course Socioeconomic Conditions and Frailty at Older Ages

Bernadette Wilhelmina Antonia Van der Linden; Boris Cheval; Stefan Sieber; Dan Orsholits; Idris Guessous; Silvia Stringhini; Rainer Gabriel; Marja Aartsen; David Blane; Delphine Courvoisier; Claudine Burton-Jeangros; Matthias Kliegel; Stéphane Cullati

doi:10.1093/geronb/gbz018

Life Course Socioeconomic Conditions and Frailty at Older Ages

J Gerontol B Psychol Sci Soc Sci. 2020 Jun 2;75(6):1348-1357. doi: 10.1093/geronb/gbz018.

Authors

Bernadette Wilhelmina Antonia Van der Linden^{1

2}, Boris Cheval¹, Stefan Sieber¹, Dan Orsholits¹, Idris Guessous^{3

4

5}, Silvia Stringhini⁶, Rainer Gabriel^{1

7}, Marja Aartsen⁸, David Blane⁹, Delphine Courvoisier^{1

3}, Claudine Burton-Jeangros¹, Matthias Kliegel^{1

2}, Stéphane Cullati^{1

10}

Affiliations

¹ Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives"Arve, Geneva, Switzerland.
² Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland.
³ Unit of Population Epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Switzerland.
⁴ Department of Epidemiology, Emory University, Atlanta, Georgia.
⁵ Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland.
⁶ Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland.
⁷ ZHAW, Zurich University of Applied Sciences, Switzerland.
⁸ NOVA - Norwegian Social Research, Center for Welfare and Labor Research, Oslo, Norway.
⁹ International Centre for Life Course Studies in Society and Health, Department of Epidemiology and Public Health, University College London, UK.
¹⁰ Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Switzerland.

Abstract

Objectives: This article aimed to assess associations of childhood socioeconomic conditions (CSC) with the risk of frailty in old age and whether adulthood socioeconomic conditions (ASC) influence this association.

Methods: Data from 21,185 individuals aged 50 years and older included in the longitudinal Survey of Health, Ageing, and Retirement in Europe were used. Frailty was operationalized as a sum of presenting weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted multilevel logistic regression models were used to analyze associations of CSC and ASC with frailty.

Results: While disadvantaged CSC was associated with higher odds of (pre-)frailty in women and men (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.34, 2.24; OR = 1.84, 95% CI 1.27, 2.66, respectively), this association was mediated by ASC. Personal factors and demographics, such as birth cohort, chronic conditions, and difficulties with activities of daily living, increased the odds of being (pre-)frail.

Discussion: Findings suggest that CSC are associated with frailty at old age. However, when taking into account ASC, this association no longer persists. The results show the importance of improving socioeconomic conditions over the whole life course in order to reduce health inequalities in old age.

Keywords: Health outcomes; Socioeconomic status; Successful aging.

Publication types

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

MeSH terms

Adverse Childhood Experiences* / economics
Adverse Childhood Experiences* / psychology
Adverse Childhood Experiences* / statistics & numerical data
Aged
Europe / epidemiology
Female
Frail Elderly / statistics & numerical data
Frailty* / diagnosis
Frailty* / economics
Frailty* / epidemiology
Frailty* / prevention & control
Geriatric Assessment / methods
Health Status Disparities
Healthy Aging* / physiology
Healthy Aging* / psychology
Humans
Life Change Events
Longitudinal Studies
Male
Social Class*
Socioeconomic Factors*

Abstract

Publication types

MeSH terms

Grants and funding