Institute of Gerontology, The University of Tokyo, Japan.
Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Japan.
J Gerontol A Biol Sci Med Sci. 2018 Jun 14;73(7):973-979. doi: 10.1093/gerona/glx171.
Increasing evidence suggests an impact of childhood disadvantage on late-life functional impairment in Western countries. However, the processes by which childhood disadvantage affects functional capacity are influenced by several factors unique to particular societies. We examined the impact of childhood disadvantage on functional decline among older Japanese, using a large-scale prospective cohort study.
Data came from surveys conducted in 2010 and 2013 as part of the Japan Gerontological Evaluation Study (JAGES), a nationwide cohort study targeting community-dwelling people aged 65 years and over. Childhood disadvantage included subjective childhood socioeconomic status (SES), body height, and educational level. The sample was stratified by age at baseline (65-69, 70-74, 75-79, and ≥ 80 years).
A total of 11,601 respondents were analyzed. In the 65-69-year group, lower childhood SES was associated with functional decline but this association was mediated by adult SES. In contrast, childhood SES was independently associated with functional decline in the older cohort. In the 75-79-year group, lower childhood SES was associated with functional decline. However, in the ≥ 80-year group, people with higher childhood SES were more likely to experience functional decline. Shorter height was associated with functional decline in the 70-74-year group. Higher education was related to functional decline in all age groups except the ≥ 80-year group.
These findings suggest that childhood disadvantage affects functional decline but its effect varies by age cohort. The mechanisms underlying the association between childhood disadvantage and functional decline may be influenced by social and historical context.
越来越多的证据表明，童年逆境对西方国家老年人的晚年功能障碍有影响。然而，童年逆境影响功能能力的过程受到特定社会特有的几个因素的影响。我们使用大规模的前瞻性队列研究，研究了童年逆境对日本老年人功能下降的影响。
数据来自 2010 年和 2013 年作为日本老年学评估研究（JAGES）一部分进行的调查，这是一项针对 65 岁及以上社区居民的全国性队列研究。童年逆境包括主观童年社会经济地位（SES）、身高和受教育程度。样本按基线年龄（65-69、70-74、75-79 和≥80 岁）分层。
共分析了 11601 名受访者。在 65-69 岁组中，较低的童年 SES 与功能下降相关，但这种关联受成人 SES 的调节。相比之下，在较年长的队列中，童年 SES 与功能下降独立相关。在 75-79 岁组中，较低的童年 SES 与功能下降相关。然而，在≥80 岁组中，童年 SES 较高的人更有可能经历功能下降。身高较低与 70-74 岁组的功能下降相关。除≥80 岁组外，较高的教育程度与所有年龄组的功能下降相关。
这些发现表明，童年逆境会影响功能下降，但它的影响因年龄组而异。童年逆境与功能下降之间的关联的潜在机制可能受到社会和历史背景的影响。
