Swiss NCCR 'LIVES - Overcoming Vulnerability: Life Course Perspectives', University of Geneva, Geneva, Switzerland
Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland.
J Epidemiol Community Health. 2019 Aug;73(8):703-711. doi: 10.1136/jech-2019-212110. Epub 2019 Apr 9.
Early-life socioeconomic circumstances (SEC) are associated with health in old age. However, epidemiological evidences on the influence of these early-life risk factors on trajectories of healthy ageing are inconsistent, preventing drawing solid conclusion about their potential influence. Here, to fill this knowledge gap, we used a statistical approach adapted to estimating change over time and an outcome-wide epidemiology approach to investigate whether early-life SEC were associated with the level of and rate of decline of physical, cognitive and emotional functioning over time.
We used data on more than 23 000 adults in older age from the Survey of Health, Ageing and Retirement in Europe, a 12-year large-scale longitudinal study with repeated measurements of multiple health indicators of the same participants over time (2004 -2015, assessments every 2 years). Confounder-adjusted linear growth curve models were used to examine the associations of early-life SEC with the evolution of muscle strength, lung function, cognitive function, depressive symptoms and well-being over time.
We consistently found an association between early-life SEC and the mean levels of all health indicators at age 63.5, with a critical role played by the cultural aspect of disadvantage. These associations were only partly explained by adult-life SEC factors. By contrast, evidences supporting an association between early-life SEC and the rate of change in health indicators were weak and inconsistent.
Early-life SEC are associated with health in old age, but not with trajectories of healthy ageing. Conceptual models in life course research should consider the possibility of a limited influence of early-life SEC on healthy ageing trajectories.
早期生活的社会经济状况（SEC）与老年健康有关。然而，关于这些早期生活风险因素对健康老龄化轨迹的影响的流行病学证据并不一致，无法得出关于它们潜在影响的可靠结论。在这里，为了填补这一知识空白，我们使用了一种适用于估计随时间变化的统计方法和一种全结局流行病学方法，来研究早期生活 SEC 是否与身体、认知和情感功能随时间的水平和下降速度有关。
我们使用了来自欧洲健康、衰老和退休调查（Survey of Health, Ageing and Retirement in Europe）的 23000 多名老年人的数据，这是一项为期 12 年的大规模纵向研究，对同一参与者的多项健康指标进行了多次重复测量（2004 年至 2015 年，每两年评估一次）。我们使用调整混杂因素的线性增长曲线模型来研究早期生活 SEC 与肌肉力量、肺功能、认知功能、抑郁症状和幸福感随时间的演变之间的关系。
我们一致发现，早期生活 SEC 与所有健康指标在 63.5 岁时的平均水平之间存在关联，而劣势的文化方面起着关键作用。这些关联部分可以用成年生活 SEC 因素来解释。相比之下，支持早期生活 SEC 与健康指标变化率之间存在关联的证据是微弱且不一致的。
早期生活 SEC 与老年健康有关，但与健康老龄化轨迹无关。生命历程研究中的概念模型应考虑早期生活 SEC 对健康老龄化轨迹的影响可能有限的可能性。
