Department of Social Medicine, University of Bristol, Bristol, United Kingdom.
PLoS One. 2011 Jan 26;6(1):e15564. doi: 10.1371/journal.pone.0015564.
Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.
Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.
Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.
握力、步行速度、起坐和站立平衡时间是身体能力的客观测量指标，可反映当前健康状况，并预测老年人的生存情况。儿童时期的社会经济地位（SEP）可能会影响成年早期达到的身体能力峰值，从而影响成年后期的身体能力水平。我们进行了一项系统评价和荟萃分析，以检验以下假设：不良的儿童 SEP 与成年后身体能力的客观测量值较低有关。
通过对 EMBASE 和 MEDLINE 进行文献检索，确定了截至 2010 年 5 月发表的相关研究。从研究调查人员处获取未发表的结果。所有研究调查人员均以标准格式提供结果，并使用随机效应荟萃分析进行汇总。共纳入 19 项研究。荟萃分析的总样本量范围从起坐时间的 N=17215 到握力的 N=1061855。尽管存在异质性，但在年龄调整模型中仍有一致的证据表明，较低的儿童 SEP 与成年后身体能力水平的适度降低有关：将最低与最高儿童 SEP 进行比较，握力降低 0.13 个标准差（95%CI：0.06，0.21），平均步行速度降低 0.07 m/s（0.05，0.10），平均起坐时间增加 6%（4%，8%），无法平衡 5 秒的比值为 1.26（1.02，1.55）。调整潜在的中介因素，如成人 SEP 和体型，大大减弱了关联。但是，尽管这种衰减，对于步行速度和起坐时间，仍然存在中度关联的证据。
针对儿童时期社会经济不平等的政策可能会在促进晚年独立方面具有额外的益处。
