Huang Ziting, Lai Eric T C, Hashimoto Hideki, Marmot Michael, Woo Jean
Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong.
Arch Gerontol Geriatr. 2025 Jun;133:105829. doi: 10.1016/j.archger.2025.105829. Epub 2025 Mar 16.
To investigate how socioeconomic positions at different life stages, their relative importance, and social mobility influence IC across the USA, UK, Europe, China, and Japan among adults aged ≥50 years.
We included 54,217 participants from five nationally representative cohorts in the USA, UK, Europe, China, and Japan. Life-course socioeconomic positions were assessed in early-life (childhood socioeconomic positions), early-adulthood (education), and late-adulthood (household wealth). Healthy aging was measured by intrinsic capacity including cognition, psychological health, locomotion, vitality, and sensory functions. Linear mixed models were used to estimate the associations of intrinsic capacity with each socioeconomic position indicator and social mobility.
Higher levels of education and wealth were both significantly associated with better intrinsic capacity (p < 0.05 in all cohorts). Education had a stronger impact on intrinsic capacity than wealth in the USA, Europe, China, and Japan. Middle and high childhood socioeconomic positions were significantly linked to better intrinsic capacity compared with the low group (p < 0.05 in all cohorts). Compared to stable groups, upward and downward social mobility groups were associated with better and worse intrinsic capacity, respectively.
Socioeconomic measures throughout the life course can predict healthy aging in the USA, Europe, and Asia. The long-term negative impact of disadvantaged childhood socioeconomic positions on healthy aging can be partially mitigated by upward mobility later in life. Policies need to narrow the social inequalities from early life and prevent adults from experiencing downward mobility, thereby reducing disparities in healthy aging.
研究在美国、英国、欧洲、中国和日本，不同生命阶段的社会经济地位、其相对重要性以及社会流动性如何影响50岁及以上成年人的内在能力（IC）。
我们纳入了来自美国、英国、欧洲、中国和日本五个具有全国代表性队列的54217名参与者。在生命早期（童年社会经济地位）、成年早期（教育程度）和成年晚期（家庭财富）评估生命历程中的社会经济地位。通过包括认知、心理健康、运动能力、活力和感官功能在内的内在能力来衡量健康老龄化。使用线性混合模型估计内在能力与每个社会经济地位指标以及社会流动性之间的关联。
较高的教育水平和财富水平均与更好的内在能力显著相关（所有队列中p<0.05）。在美国、欧洲、中国和日本，教育对内在能力的影响比财富更强。与低分组相比，童年时期中等和高社会经济地位与更好的内在能力显著相关（所有队列中p<0.05）。与稳定组相比，社会向上流动组和向下流动组分别与更好和更差的内在能力相关。
生命历程中的社会经济指标可以预测美国、欧洲和亚洲的健康老龄化。童年时期处于不利社会经济地位对健康老龄化的长期负面影响可以通过生命后期的向上流动得到部分缓解。政策需要从生命早期缩小社会不平等，并防止成年人经历向下流动，从而减少健康老龄化方面的差异。
