Childhood socioeconomic circumstances and disability trajectories in older men and women: a European cohort study

Abstract

Background We observed a lack of population-based longitudinal research examining the association of disadvantaged childhood socioeconomic circumstances (CSC) and disability [activities of daily living (ADL) and instrumental activities of daily living (IADL)] in older age, and whether socioeconomic attainments in adulthood can compensate for a poor socioeconomic start in life. Methods Data on 24 440 persons aged 50–96 in 14 European countries (Survey of Health, Ageing and Retirement in Europe) were used to measure the associations between CSC and limitations with ADL and with IADL, using mixed-effects logistic regression models. Models stratified by gender were adjusted for education during young adulthood, main occupation during middle age, ability to make ends meet during old age and potential confounding and control variables. Results Risks of ADL and IADL limitations increased with age and were different between women and men. For women, a gradient across CSC strata was observed, showing that the more disadvantaged the CSC, the higher the risk of ADL and IADL limitations in old age, even after adjustment for adult socioeconomic indicators. For men, the association between CSC and disability was mediated by the main occupation in middle age and the ability to make ends meet at older age. Conclusion Women who grew up in socioeconomically disadvantaged households were at higher risk of disability in older age and this disadvantage was not attenuated by favourable adult socioeconomic conditions. Men were more likely to make up for a disadvantaged start in adulthood.

Instrumental Activities of Daily Living (iADL) Limitations in Europe: An Assessment of SHARE Data

“…In fact, economic disadvantages, health inequalities and risky behaviours during an individual’s life course are reflected in increased risk of disability in old age. This occurs due to poor health choices, risky behaviours and the lack of health-related treatment opportunities [ 3 , 28 , 32 , 33 ]. Hence, fewer years of education and frequent money shortage were associated with an increased prevalence of iADLs limitations.…”

“…The growing requirement for formal and informal care, as a consequence of PD in late adulthood, has increased the demand for healthcare services. This has led to financial expenditure increases associated with the diminished labour force and increased pensions, public costs and health and long-term care [ 3 , 4 , 5 ].…”

“…A key effect of iADLs on self-management and self-care activities has been that iADLs limits are expected to precede ADLs shortfalls. This outlines a need for interventions capable of limiting the onset of ADLs dependence [ 1 , 3 , 6 ]. Indeed, this study aims to evaluate iADLs limitations in 17 European countries and Israel, and their associations with sociodemographic characteristics, economic parameters, physical status, psychological domain and lifestyle using the Survey of Health, Ageing, and Retirement in Europe (SHARE), a population-based survey.…”

The role of adult socioeconomic and relational reserves regarding the effect of childhood misfortune on late-life depressive symptoms

“…These four binary indicators served to create an index of childhood socioeconomic circumstances with five categories ranging from “most disadvantaged” to “most advantaged”. Disadvantaged CSC have been shown to predict a wide range of health indicators, including muscle strength (Cheval, Boisgontier, et al, 2018), lung function (Cheval, Chabert, et al, 2018), frailty (van der Linden et al, 2017), disability (Landös et al, 2018), and physical inactivity (Cheval, Sieber, et al, 2018).…”

Concepts and Social Variations of Disability in Working-Age Populations

“…Therefore, extending access to health care, while important, may not be sufficient to reduce the social gradient of limitations of activity and social participation among middle-aged and early-old-age populations (see below). Obviously, these consistent social inequalities have their roots in differential health-related, behavioral, psychosocial, and socioeconomic vulnerability in earlier stages of life (e.g., Landös et al 2018). While it is beyond the current contribution to analyze these risk and protective factors, the question of interest here concerns the longer-term consequences of incident midlife disability for work ability and premature exit from labor market.…”