Paul Baerwald School of Social Work, The Hebrew University of Jerusalem, Mount Scopus, 91905, Jerusalem, Israel.
Paul Baerwald School of Social Work, The Hebrew University of Jerusalem, Mount Scopus, 91905, Jerusalem, Israel.
Soc Sci Med. 2021 Nov;289:114407. doi: 10.1016/j.socscimed.2021.114407. Epub 2021 Sep 16.
Although several studies have demonstrated the associations between lifetime cumulative adversity and late-life physical health, many of them were conducted at a single time point and examined events that occurred in childhood only. Less is known about the effect of lifelong adversity on the aging process over time. This study aimed to investigate the impact of cumulative adversity on the accelerated deterioration in health over time - mobility limitation and self-rated state of health in old age.
This study provides a 14-year, 6-time-point follow-up on a representative sample of Europeans using the SHARE Project - longitudinal survey panel. The sample included a total of 7195 respondents aged 65 and older from nine countries in Europe. The outcome measurements were the number of mobility limitations and self-rated health - trajectories along 6 measurements. The independent variable was Lifetime Cumulative Adversity, and the analyses included also control variables - age, gender, socioeconomic status, depression, and country.
Time-based Latent Growth Curve Modeling has demonstrated that the effects of Lifetime Cumulative Adversity were significant on both health measures, by means of the intercepts and the slopes: Greater experience of adversities correlated with a higher physical health impairment at baseline and a higher decline along time. The effects of self-rated health were weaker than the effects of mobility limitations.
Given that the populations of numerous countries are rapidly aging, understanding the risk factors associated with health deterioration is important, especially for policymakers and medical health care experts, to raise awareness of the relationship between lifelong adversity and health decline and to build preventive interventions to deal with these consequences.
尽管多项研究表明，终生累积逆境与晚年身体健康之间存在关联，但其中许多研究仅在单个时间点进行，且仅考察了儿童时期发生的事件。对于终生逆境对随时间推移的衰老过程对健康的影响，我们知之甚少。本研究旨在探讨累积逆境对健康随时间加速恶化的影响，即老年时的行动受限和自我评估健康状况。
本研究利用 SHARE 项目（欧洲纵向调查面板）对欧洲代表性样本进行了为期 14 年、6 次时间点的随访。该样本包括来自欧洲 9 个国家的 7195 名 65 岁及以上的受访者。测量的结果是行动受限的数量和自我评估的健康状况-沿着 6 次测量的轨迹。自变量为终生累积逆境，分析还包括年龄、性别、社会经济地位、抑郁和国家等控制变量。
基于时间的潜在增长曲线模型表明，终生累积逆境对两种健康指标的影响都是显著的，表现在截距和斜率上：经历更多逆境与基线时的身体健康损害更大以及随时间推移的下降幅度更大相关。自我评估健康状况的影响比行动受限的影响弱。
鉴于许多国家的人口正在迅速老龄化，了解与健康恶化相关的风险因素非常重要，特别是对于政策制定者和医疗保健专家而言，这有助于提高他们对终生逆境与健康衰退之间关系的认识，并制定预防干预措施来应对这些后果。
