Childhood Socioeconomic Position and Objectively Measured Physical Capability Levels in Adulthood: A Systematic Review and Meta-Analysis

Department of Social Medicine, University of Bristol, Bristol, United Kingdom.
PLoS ONE (Impact Factor: 3.23). 01/2011; 6(1):e15564. DOI: 10.1371/journal.pone.0015564
Source: PubMed


Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.
Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.
Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.

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Available from: Alan J. Gow, Oct 06, 2015
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    • "A previous report from SHARE identified that grip strength was inversely related to education and wealth.(12) Multiple studies have identified that adverse socioeconomic circumstances early in life are independently associated with weak grip strength in middle-age,(17,18) but more recent socioeconomic circumstances appear to be more important.(18) Cognitive impairment has also been associated with adverse social and environmental factors across the life course, including among international migrants who were born in lower income countries.(19) "
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    ABSTRACT: Background Life course influences, including country of residence and country of birth, are associated with frailty index scores. We investigated these associations using performance-based health measures. Methods Among 33,745 participants age 50+ (mean age 64.8 ± 10.1; 55% women) in the Survey of Health, Ageing, and Retirement in Europe, grip strength, delayed word recall, and semantic verbal fluency were assessed. Participants were grouped by country of residence (Northern/Western Europe or Southern/Eastern Europe), and by country of birth (native-born, immigrants born in low- and middle-income countries [LMICs], or immigrants born in high-income countries [HICs]). Results Participants in Southern/Eastern Europe had lower mean test scores than those in Northern/Western Europe, and their scores did not differ by country of birth group. In Northern/Western Europe, compared with native-born participants, LMIC-born immigrants demonstrated lower mean grip strength (32.8 ± 7.6 kg vs. 35.7 ± 7.7 kg), delayed recall (2.9 ± 1.9 vs. 3.6 ± 1.9), and verbal fluency scores (16.0 ± 6.9 vs. 20.3 ± 7.0). HIC-born immigrants had mean scores higher than LMIC-born immigrants, but lower than native-born participants (all p<.001). Conclusions Cognitive and motor performance, measured from late middle age, were associated with national income levels of both country of residence and country of birth. This was similar to previously observed differences in frailty index scores.
    09/2014; 17(3):103-7. DOI:10.5770/cgj.17.114
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    • "The challenge lies in the appropriate parameterisation of each hypothesis (De Stavola and Daniel, 2012), an endeavour that requires suitable statistical tools, beyond standard analytical methods. With some exceptions (Bartley et al., 2012; Chandola et al., 2006; Nandi et al., 2012), the vast majority of the evidence concerning life course processes comes from studies that have relied on standard regression models (Birnie et al., 2011; De Stavola et al., 2006). Such models allow only limited conclusions to be drawn about the relative importance of the hypothesised life course pathways which lead to socioeconomic disparities in later life health. "
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    ABSTRACT: The relative contribution of early or later life Socio Economic Position (SEP) to later life health is not fully understood and there are alternative hypotheses about the pathways through which they may influence health. We used data from the English Longitudinal Study of Ageing with a formal approach for the identification of mediating factors in order to investigate alternative hypotheses about life course influences on biomarkers of later life health. We found that early life SEP predicts physical health at least 65 years later. However, a more complicated pattern of associations than that implied by previous findings was also observed. Age group specific effects emerged, with current SEP dominating the effect on later life physical health and fibrinogen levels in participants under 65, while early life SEP had a more prominent role in explaining inequalities in physical health for men and women over 75. We extend previous findings on mid adulthood and early old age, to old age and the beginnings of late old age. The complexity of our findings highlights the need for further research on the mechanisms that underlie the association between SEP and later life health.
    Social Science [?] Medicine 02/2014; 119. DOI:10.1016/j.socscimed.2014.02.018 · 2.89 Impact Factor
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    • "Epidemiological studies have increasingly emphasized the lasting health impact of early-life circumstances [10-12]. While research on the relevance of childhood SES in arthritis remains at an early stage, there is mounting evidence for plausible mechanisms. "
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    ABSTRACT: Associations of socioeconomic status (SES) with the prevalence of various forms of arthritis are well documented. Increasing evidence suggests that SES during childhood is a lasting determinant of health, but its association with the onset of arthritis remains unclear. Cross-sectional data on 1276 participants originated from 22 family practices in North-Carolina, USA. We created 4-level (high, medium, low, lowest) current SES and childhood SES summary scores based on parental and participant education, occupation and homeownership. We investigated associations of individual SES characteristics, summary scores and SES trajectories (e.g. high/low) with self-reported arthritis in logistic regression models progressively adjusted for race and gender, age, then BMI, and clustered by family practice. We found evidence for independent associations of both childhood and current SES with the reporting of arthritis across our models. In covariate-adjusted models simultaneously including current and childhood SES, compared with high SES participants in the lowest childhood SES category (OR = 1.39 [95%CI = 1.04, 1.85]) and those in the low (OR = 1.66 [95%CI = 1.14, 2.42]) and lowest (OR = 2.08 [95%CI = 1.16, 3.74]) categories of current SES had significantly greater odds of having self-reported arthritis. Current SES and childhood SES are both associated with the odds of reporting arthritis within this primary-care population, although the possibly superseding influence of existing circumstances must be noted. BMI was a likely mechanism in the association of childhood SES with arthritis onset, and research is needed to elucidate further pathways linking the socioeconomic environment across life-stages and the development of rheumatic diseases.
    BMC Musculoskeletal Disorders 11/2013; 14(1):327. DOI:10.1186/1471-2474-14-327 · 1.72 Impact Factor
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