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成年后连续22年的经济困难与早衰标志物:身体能力、认知功能和炎症

Economic hardship over twenty-two consecutive years of adult life and markers of early ageing: physical capability, cognitive function and inflammation.

作者信息

Foverskov Else, Petersen Gitte Lindved, Pedersen Jolene Lee Masters, Rod Naja Hulvej, Mortensen Erik Lykke, Bruunsgaard Helle, Lund Rikke

机构信息

1Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

2Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.

出版信息

Eur J Ageing. 2019 Jul 5;17(1):55-67. doi: 10.1007/s10433-019-00523-z. eCollection 2020 Mar.

Abstract

This study assesses the associations between annual measures of economic hardship (EH) across 22 years of adulthood and objective measures of early ageing in a Danish late-middle-aged population ( = 5575). EH (years < 60% of the National median equivalized household disposable income) was experienced by 18% during 1987-2008. Four or more years in EH (reference = null years in EH) was related to poorer physical capability (chair rise: - 1.49 counts/30 s [95% confidence interval (CI) - 2.36, - 0.61], hand grip strength: - 1.22 kg [95% CI - 2.38, - 0.07], jump height: - 1.67 cm [95% CI - 2.44, - 0.91] and balance: 18% [95% CI 9, 28]), poorer cognitive function (Intelligenz-Struktur-Test: - 1.50 points [95% CI - 2.89, - 0.12]) and higher inflammatory levels (C-reactive protein: 22% [95% CI 4, 44], and Interleukin-6: 23% [95% CI 10, 39]). Comparing four EH trajectories, people with a high versus low probability of EH over time had poorer physical capability (chair rise: - 1.70 counts/30 s [95% CI - 3.38, - 0.01], grip: - 4.33 kg [95% CI - 6.50, - 2.16], jump: - 1.68 cm [95% CI - 3.12, - 0.25] and balance: 31% [95% CI 12, 52]). No associations were observed with tumour necrosis factor-α. Results were adjusted for sex, age, long-term parental unemployment/financial problems, education, baseline income and cohort. This study suggested EH for four or more years to be associated with poorer physical capability, cognitive function and increased inflammatory levels in midlife. High probability of EH across adulthood was similarly related to poorer physical capability and CRP, but not cognitive function and the remaining inflammatory markers. In conclusion, preventive initiatives focusing on reducing the burden of sustained economic hardship may lead to increased healthy ageing.

摘要

本研究评估了丹麦中年晚期人群(n = 5575)成年期22年间经济困难(EH)年度指标与早期衰老客观指标之间的关联。在1987 - 2008年期间,18%的人经历过经济困难(年份低于全国家庭可支配收入中位数等效值的60%)。经历四年或更长时间经济困难(参照 = 无经济困难年份)与身体能力较差有关(从椅子上起身:-1.49次/30秒[95%置信区间(CI)-2.36,-0.61],握力:-1.22千克[95% CI -2.38,-0.07],跳跃高度:-1.67厘米[95% CI -2.44,-0.91],平衡能力:18%[95% CI 9,28]),认知功能较差(智力结构测试:-1.50分[95% CI -2.89,-0.12])以及炎症水平较高(C反应蛋白:22%[95% CI 4,44],白细胞介素-6:23%[95% CI 10,39])。比较四种经济困难轨迹,随着时间推移经济困难概率高与低的人群相比,身体能力较差(从椅子上起身:-1.70次/30秒[95% CI -3.38,-0.01],握力:-4.33千克[95% CI -6.50,-2.16],跳跃:-1.68厘米[95% CI -3.12,-0.25],平衡能力:31%[95% CI 12,52])。未观察到与肿瘤坏死因子-α的关联。结果针对性别、年龄、长期父母失业/经济问题、教育程度、基线收入和队列进行了调整。本研究表明,四年或更长时间的经济困难与中年时较差的身体能力、认知功能以及炎症水平升高有关。成年期经济困难概率高同样与较差的身体能力和C反应蛋白有关,但与认知功能及其他炎症标志物无关。总之,侧重于减轻持续经济困难负担的预防措施可能会促进健康老龄化。

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