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Ahmmed F, Hossain MJ, Khan MTF, Manik MMR, Shahriar S, Nandi DC, Hussain MP. Mediating effect of BMI on the association of economic status and coexistence of hypertension and diabetes in Bangladesh: A counterfactual framework-based weighting approach. Health Sci Rep 2024; 7:e2063. [PMID: 38660004 PMCID: PMC11039488 DOI: 10.1002/hsr2.2063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 03/31/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024] Open
Abstract
Background and Aims Non-communicable diseases such as hypertension and diabetes are matters of huge concern worldwide, with an increasing trend in prevalence over the previous decade. First of all, this study aimed to evaluate the association between economic status (ES) and body mass index (BMI), ES and comorbidity of hypertension and diabetes, and BMI and comorbidity independently. Second, it explored the mediating role of BMI in the association between ES and comorbidity of hypertension and diabetes. Finally, it investigated whether the mediating effect differs with the place of residence, gender, and education levels. Methods A total of 11,291 complete cases from the Bangladesh demographic and health survey 2017-18 were utilized for this study. Survey-based binary logistic regression or multiple logistic regression was used to find the association among outcome, exposure, and mediator variables, and a counterfactual framework-based weighting approach was utilized for mediation analysis. Results Middle-income (adjusted odds ratio [AOR]: 1.696, 95% confidence interval [CI]: 1.219, 2.360) and rich (AOR: 2.770, CI: 2.054, 3.736) respondents were more likely to have comorbidity of hypertension and diabetes compared to the poor. The odds of comorbidity increased with the increase in BMI. A positive association was observed between ES and BMI. A significant mediating role of BMI in the association between ES and comorbidity was found. We observed that 19.85% (95% CI: 11.50%, 49.6%) and 20.35% (95% CI: 14.9%, 29.3%) of total effect was mediated by BMI for middle and rich respondents, respectively, compared to the poor. Conclusions The mediating role of BMI was greater for female, no or primary educated respondents, and respondents from rural areas. Therefore, the study will facilitate policymakers of Bangladesh and other countries with a similar set-up to decide on health policies regarding hypertension and diabetes.
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Affiliation(s)
- Foyez Ahmmed
- Department of StatisticsComilla UniversityCumillaBangladesh
- Department of Biostatistics & Data ScienceUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Md. Jamal Hossain
- Department of Pharmacy, School of Pharmaceutical SciencesState University of BangladeshDhakaBangladesh
| | | | | | - Saimon Shahriar
- Department of Pharmacy, School of Pharmaceutical SciencesState University of BangladeshDhakaBangladesh
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Duchowny KA, Marcinek DJ, Mau T, Diaz-Ramierz LG, Lui LY, Toledo FGS, Cawthon PM, Hepple RT, Kramer PA, Newman AB, Kritchevsky SB, Cummings SR, Coen PM, Molina AJA. Childhood adverse life events and skeletal muscle mitochondrial function. SCIENCE ADVANCES 2024; 10:eadj6411. [PMID: 38446898 PMCID: PMC10917337 DOI: 10.1126/sciadv.adj6411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 02/01/2024] [Indexed: 03/08/2024]
Abstract
Social stress experienced in childhood is associated with adverse health later in life. Mitochondrial function has been implicated as a mechanism for how stressful life events "get under the skin" to influence physical well-being. Using data from the Study of Muscle, Mobility, and Aging (n = 879, 59% women), linear models examined whether adverse childhood events (i.e., physical abuse) were associated with two measures of skeletal muscle mitochondrial energetics in older adults: (i) maximal adenosine triphosphate production (ATPmax) and (ii) maximal state 3 respiration (Max OXPHOS). Forty-five percent of the sample reported experiencing one or more adverse childhood events. After adjustment, each additional event was associated with -0.08 SD (95% confidence interval = -0.13, -0.02) lower ATPmax. No association was observed with Max OXPHOS. Adverse childhood events are associated with lower ATP production in later life. Findings indicate that mitochondrial function may be a mechanism for understanding how early social stress influences health in later life.
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Affiliation(s)
- Kate A. Duchowny
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - Theresa Mau
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - L. Grisell Diaz-Ramierz
- Division of Geriatrics, Department of Medicine, UCSF School of Medicine, San Francisco, CA, USA
| | - Li-Yung Lui
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Frederico G. S. Toledo
- Department of Medicine, Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peggy M. Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Russell T. Hepple
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Philip A. Kramer
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Anne B. Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen B. Kritchevsky
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R. Cummings
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Paul M. Coen
- AdventHealth, Translational Research Institute, Orlando, FL, USA
| | - Anthony J. A. Molina
- Department of Medicine-Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego School of Medicine, La Jolla, CA, USA
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Duchowny KA, Mau T, Diaz-Ramierz LG, Lui LY, Marcinek DJ, Toledo FGS, Cawthon PM, Hepple RT, Kramer PA, Newman AB, Kritchevsky SB, Cummings SR, Coen PM, Molina AJA. Childhood adverse life events and skeletal muscle mitochondrial function. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.07.23298177. [PMID: 37986889 PMCID: PMC10659458 DOI: 10.1101/2023.11.07.23298177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Social stress experienced in childhood is associated with adverse health later in life. Mitochondrial function has been implicated as a mechanism for how stressful life events "get under the skin" to influence physical wellbeing. Using data from the Study of Muscle, Mobility and Aging (n=879, 59% women), linear models examined whether adverse childhood events (i.e., physical abuse) were associated with two measures of skeletal muscle mitochondrial energetics in older adults: (1) maximal adenosine triphosphate production (ATP max ) and (2) maximal state 3 respiration (Max OXPHOS). Forty-five percent of the sample reported experiencing 1+ adverse childhood event. After adjustment, each additional event was associated with -0.07 SD (95% CI= - 0.12, -0.01) lower ATP max . No association was observed with Max OXPHOS. Adverse childhood events are associated with lower ATP production in later life. Findings indicate that mitochondrial function may be a mechanism in understanding how early social stress influences health in later life.
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Katanic B, Bjelica D, Stankovic M, Milosevic Z, Vukovic J, Mekic A. Anthropometric Characteristics and Weight Status of Early Adolescents (Aged 12-14) in Montenegro; Urban-Rural and Regional Differences. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1664. [PMID: 37892327 PMCID: PMC10605907 DOI: 10.3390/children10101664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
The aim of this study was to determine urban-rural and regional differences in anthropometric characteristics among adolescents aged 12-14, as well as to present the prevalence of weight status. A total of 534 adolescents aged 12-14 from primary schools across Montenegro participated in this cross-sectional study (283 boys, aged 13.52 ± 0.42, body height 169.43 ± 8.89, body weight 60.54 ± 13.47; 251 girls, aged 13.51 ± 0.40, body height 165.54 ± 6.67, body weight 55.28 ± 9.27). The sample was divided by geographic region in Montenegro into northern, central, and coastal regions, and according to settlement type into urban and rural inhabitants. Anthropometric characteristics were assessed using a battery of seven variables: arm span (AS); body height (BH); body weight (BW); waist circumference (WC); hip circumference (HC); body mass index (BMI); and waist-to-hip ratio (WHR). BMI was categorized based on the World Health Organization's (WHO) cut-offs. The results indicate that girls from urban areas exhibited significantly greater body height and lower BMI values compared to their rural counterparts. Similarly, boys from urban areas also demonstrated lower BMI values compared to their rural peers. However, no statistically significant differences were observed in other anthropometric characteristics between these two groups of adolescents. Based on analysis of variance (ANOVA) and post-hoc analysis, it was found that girls from central areas had significantly greater body height compared to those from northern and coastal areas. Likewise, boys from northern areas showed higher body mass and BMI values compared to those from central areas. Additionally, both boys and girls from central areas had higher values compared to those from coastal areas. Nevertheless, no significant differences were detected in other anthropometric characteristics among adolescents from these regions. This study identified significant differences in anthropometric parameters among participants based on urban-rural status and within regional divisions. However, further research encompassing a larger sub-sample and a broader array of anthropometric variables is needed to draw a more comprehensive conclusion.
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Affiliation(s)
- Borko Katanic
- Faculty of Sport and Physical Education, University of Nis, 18000 Nis, Serbia;
| | - Dusko Bjelica
- Faculty for Sports and Physical Education, University of Montenegro, 81400 Niksic, Montenegro;
| | - Mima Stankovic
- Faculty of Sport and Physical Education, University of Nis, 18000 Nis, Serbia;
| | - Zoran Milosevic
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.M.); (J.V.)
| | - Jovan Vukovic
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia; (Z.M.); (J.V.)
| | - Amel Mekic
- Faculty of Sports and Physical Education, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
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Yusuf M, Montgomery G, Hamer M, McPhee J, Cooper R. Associations between childhood and adulthood socioeconomic position and grip strength at age 46 years: findings from the 1970 British Cohort Study. BMC Public Health 2022; 22:1427. [PMID: 35883072 PMCID: PMC9327373 DOI: 10.1186/s12889-022-13804-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Muscle weakness is a key criterion for important age-related conditions, including sarcopenia and frailty. Research suggests lower childhood socioeconomic position (SEP) may be associated with muscle weakness in later life but there is little evidence on associations in younger adults closer to peak muscle strength. We aimed to examine relationships between indicators of SEP in childhood and adulthood and grip strength at age 46y. METHODS We examined 7,617 participants from the 1970 British Cohort Study with grip strength measurements at 46y. We used sex-specific linear regression models to test associations between five different indicators of SEP in childhood and adulthood (paternal occupational class and parental education levels at age 5 and own occupational class and education level at age 46) and maximum grip strength. Models were adjusted for birth weight, BMI in childhood and adulthood, adult height, disability in childhood, leisure-time physical activity in childhood and adulthood, sedentary behaviour in childhood and adulthood, occupational activity and smoking at age 46. RESULTS Among women, lower SEP in childhood and adulthood was associated with weaker grip strength even after adjustments for covariates. For example, in fully-adjusted models, women whose mothers had no qualifications at age five had mean grip strength 0.99 kg (95% CI: -1.65, -0.33) lower than women whose mothers were educated to degree and higher. Among men, lower levels of father's education and both adult SEP indicators were associated with stronger grip. The association between own occupational class and grip strength deviated from linearity; men in skilled-manual occupations (i.e. the middle occupational group) had stronger grip than men in the highest occupational group (Difference in means: 1.33 kg (0.60, 2.06)) whereas there was no difference in grip strength between the highest and lowest occupational groups. Adjustment for occupational activity largely attenuated these associations. CONCLUSION Findings highlight the need to identify age and sex-specific interventions across life to tackle inequalities in important age-related conditions related to weakness.
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Affiliation(s)
- Mohamed Yusuf
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, 99 Oxford Road, Manchester, M1 7EL, UK. .,Manchester Metropolitan University Institute of Sport, Manchester, UK.
| | - Gallin Montgomery
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, 99 Oxford Road, Manchester, M1 7EL, UK.,Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Mark Hamer
- Institute of Sport, Exercise & Health, Division of Surgery & Interventional Science, University College London, 170 Tottenham Court Road, London, W1T 7HA, UK
| | - Jamie McPhee
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, 99 Oxford Road, Manchester, M1 7EL, UK.,Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, 99 Oxford Road, Manchester, M1 7EL, UK.,Manchester Metropolitan University Institute of Sport, Manchester, UK.,AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Blodgett JM, Cooper R, Pinto Pereira SM, Hamer M. Stability of Balance Performance From Childhood to Midlife. Pediatrics 2022; 150:188250. [PMID: 35670126 DOI: 10.1542/peds.2021-055861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Balance ability underlies most physical movement across life, with particular importance for older adults. No study has investigated if balance ability is established in childhood nor if associations are independent of adult factors. We investigated associations between balance performance in early (age 10) and midlife (age 46), and whether associations were independent of contributors to adult balance. METHODS Up to 6024 individuals from the 1970 British Cohort Study were included. At age 10, static (1-legged stand) and dynamic (backward toe-to-heel walk) balance were categorized as poor, medium, or high. Eyes open and closed 1-legged balance performance (max: 30 seconds) was assessed at age 46 with 5 categories. RESULTS Poor static balance at age 10 was strongly associated with worse balance ability at age 46. Relative to the highest balance group at age 46 (ie, eyes open and closed for 30 seconds), those with poor static balance had a 7.07 (4.92-10.16) greater risk of being in the poorest balance group (ie, eyes open <15 seconds). Associations were robust to adjustment for childhood illness, cognition, and socioeconomic position and adult measures of height, BMI, education, exercise, word recall, and grip strength (adjusted relative risk: 5.04 [95% confidence interval: 3.46-7.37]). Associations between dynamic balance at age 10 and balance at age 46 were weaker (adjusted relative risk) of the poorest balance group: 1.84 [1.30-2.62]). CONCLUSIONS Early childhood may represent an important period for maturation of postural strategies involved in balance, indicating the potential for early intervention and policy changes alongside existing interventions that currently target older adults.
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Affiliation(s)
- Joanna M Blodgett
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London, United Kingdom
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
| | - Snehal M Pinto Pereira
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London, United Kingdom
| | - Mark Hamer
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London, United Kingdom
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Arroyo P, Esparza-Aguilar M, Martín-Martín V, Gomez-Verjan JC, Parra-Rodríguez L, Cadena-Trejo C, Salazar-Pérez C, Gutiérrez-Robledo LM. Physical capability in a rural birth cohort at the age of 52: association with early environmental, nutritional, and developmental factors. BMC Geriatr 2022; 22:113. [PMID: 35144547 PMCID: PMC8832669 DOI: 10.1186/s12877-022-02801-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/20/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Midlife physical capability (PC) is associated with developmental factors in the populations of economically developed countries. As far as we know, there is no information for rural populations of low- and middle-income countries. The aim of the study was to investigate the influence of pre- and postnatal factors on midlife objective measures of PC in a 1966–67 birth cohort from a Mexican rural community. The hypothesis was that adverse developmental conditions are associated with low midlife PC. Methods In 1966–67, a birth cohort of all children from a poor Mexican rural community was assembled. Data on family socioeconomic status (SES), parental health and nutritional status, birth weight, postnatal growth and feeding patterns were registered. In 2018, out of the 336 cohort members, 118 were living in the community, and eighty-two of them underwent a comprehensive clinical evaluation. The evaluation included grip strength, gait velocity and chair-stand PC tests. In multivariable linear models, PC tests were the dependent variables, and prenatal, birth and postnatal factors were the independent variables. Adjustment for confounding was made with adult anthropometric, body composition, clinical and ageing status variables. Results Independent of adult health status and other ageing indicators, lower PC was associated with family organization and SES, parental nutritional status, birth weight, infant postnatal growth velocity, and weaning time. These results indicate that adverse family and environmental conditions that are prevalent in poor rural communities are associated with low midlife PC.
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Affiliation(s)
- Pedro Arroyo
- Department of Clinical Epidemiology, Direction of Research, Instituto Nacional de Geriatría, Blvd. Adolfo Ruiz Cortines No. 2767, Col. San Jerónimo Lídice, Alcaldía La Magdalena Contreras. Distrito Federal, CP. 10200, Ciudad de México, México
| | - Marcelino Esparza-Aguilar
- Research Unit of Epidemiology, Direction of Research, Instituto Nacional de Pediatría, Insurgentes Sur 3700, Letra C, Alcaldía Coyoacán, C.P. 04530, Ciudad de México, México.
| | - Verónica Martín-Martín
- Research Unit of Epidemiology, Instituto Nacional de Pediatría, Insurgentes Sur 3700, Letra C, Alcaldía Coyoacán, C.P. 04530, Ciudad de México, México
| | - Juan Carlos Gomez-Verjan
- Dirección de Investigación, Instituto Nacional de Geriatría, Col. San Jerónimo Lídice, Alcaldía La Magdalena Contreras. Distrito Federal, Blvd. Adolfo Ruiz Cortines No. 2767, CP. 10200, Ciudad de México, México
| | - Lorena Parra-Rodríguez
- Department of Biomedical Engineering and Gerontechnology. Direction of Research, Instituto Nacional de Geriatría, Blvd. Adolfo Ruiz Cortines No. 2767, Col. San Jerónimo Lídice, Alcaldía La Magdalena Contreras. Distrito Federal, CP. 10200, Ciudad de México, México
| | - Cinthya Cadena-Trejo
- Department of Clinical Epidemiology, Direction of Research, Instituto Nacional de Geriatría, Blvd. Adolfo Ruiz Cortines No. 2767, Col. San Jerónimo Lídice, Alcaldía La Magdalena Contreras. Distrito Federal, CP. 10200, Ciudad de México, México
| | - Cecilia Salazar-Pérez
- Clinical Laboratory, Instituto Nacional de Pediatría. Laboratory of Clinical Chemistry, Insurgentes Sur 3700, Letra C, Alcaldía Coyoacán, C.P. 04530, Ciudad de México, México
| | - Luis Miguel Gutiérrez-Robledo
- Instituto Nacional de Geriatría, Blvd. Adolfo Ruiz Cortines No. 2767, Col. San Jerónimo Lídice, Alcaldía La Magdalena Contreras. Distrito Federal, CP. 10200, Ciudad de México, México
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Sugisawa H, Shimizu Y, Kumagai T, Shishido K, Shinoda T. Influences of Financial Strains Over the Life Course Before Initiating Hemodialysis on Health Outcomes Among Older Japanese Patients: A Retrospective Study in Japan. Int J Nephrol Renovasc Dis 2022; 15:63-75. [PMID: 35250296 PMCID: PMC8893145 DOI: 10.2147/ijnrd.s352174] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/29/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Hidehiro Sugisawa
- International Graduate School for Advanced Studies, J. F. Oberlin University, Machida-city, Tokyo, Japan
- Correspondence: Hidehiro Sugisawa, International Graduate School for Advanced Studies, J. F. Oberlin University, 3758, Machida-city, Tokyo, 194-0294, Japan, Tel/Fax +81(0)02-797-9847, Email
| | - Yumiko Shimizu
- The Jikei University School of Nursing, Chofu-city, Tokyo, Japan
| | - Tamaki Kumagai
- Graduate School of Health Sciences at Odawara, International University of Health and Welfare, Odawara-city, Kanagawa, Japan
| | | | - Toshio Shinoda
- Faculty of Medical and Health Sciences, Tsukuba International University, Tsuchiura-city, Ibaraki, Japan
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Melchior M. Invited Commentary: Is the Long Shadow of Childhood Disadvantage on Lifelong Health Getting Worse Over Time? Am J Epidemiol 2021; 190:2294-2296. [PMID: 34100079 DOI: 10.1093/aje/kwab168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 03/31/2021] [Accepted: 04/05/2021] [Indexed: 12/17/2022] Open
Abstract
Social inequalities in health and their early-life origins have been extensively documented. Although the complex direct and intermediate mechanisms linking early-life disadvantage to later health are not yet fully understood, new findings on biological markers distinctly related with early-life experiences suggest a causal relationship. In this issue, Fuller-Rowell et al. (Am J Epidemiol. 2021:190(11):2284-2293) step back to examine the role of childhood disadvantage in the United States in different periods, observing that the relationship with later health seems to have strengthened over time. The main explanation the authors bring up has to do with increased income segregation and changes in labor market composition that limit opportunities for persons with low educational attainment. In other words, while the rich get richer, the poor get poorer, the middle class shrinks, and there are fewer interactions across different socioeconomic groups and the social ladder is blocked. Other evidence suggests that investments in children, through early education and academic support programs, could help reduce the consequences of childhood disadvantage on long-term health.
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Bjerregaard P, Ottendahl CB, Jørgensen ME. Hand grip strength and chair stand test amongst Greenlandic Inuit: reference values and international comparisons. Int J Circumpolar Health 2021; 80:1966186. [PMID: 34423740 PMCID: PMC8386702 DOI: 10.1080/22423982.2021.1966186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Muscle strength is an important predictor for function and mortality among older adults. We measured hand grip strength among 1442 participants aged 15+ years and carried out a 30 second chair stand test among 786 participants aged 55+ years. Neither test has been carried out among the Inuit before. We present reference values for men and women as means with standard deviations and medians with 10th, 25th, 75th and 90th percentiles. Hand grip strength was higher among men than among women (means 45.2 kg and 25.8 kg; p < 0.0001), in linear regression analyses it increased with height (βmen = 0.69; βwomen = 0.46), weight (βmen = 0.24; βwomen = 0.08) and body mass index (βmen = 0.56; βwomen = 0.24), and decreased with age (βmen = −0.49; βwomen = −0.29) and Inuit genetic ancestry (βmen = −0.96; βwomen = −0.59). Chair stand score showed similar associations with sex (mean score for men and women 13.8 and 11.5; p < 0.0001), age (βmen = −0.22; βwomen = −0.20) and Inuit genetic ancestry (βmen = −0.38; βwomen = −0.41). The hand grip strength of the Inuit was at the same level as in European and North American populations whereas chair stand score was lower than that of a mostly white US population.
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Affiliation(s)
- Peter Bjerregaard
- National Institute Of Public Health, University Of Southern Denmark, Denmark
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Gondek D, Bann D, Brown M, Hamer M, Sullivan A, Ploubidis GB. Prevalence and early-life determinants of mid-life multimorbidity: evidence from the 1970 British birth cohort. BMC Public Health 2021; 21:1319. [PMID: 34315472 PMCID: PMC8317357 DOI: 10.1186/s12889-021-11291-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We sought to: [1] estimate the prevalence of multimorbidity at age 46-48 in the 1970 British Cohort Study-a nationally representative sample in mid-life; and [2] examine the association between early-life characteristics and mid-life multimorbidity. METHOD A prospective longitudinal birth cohort of a community-based sample from the 1970 British Cohort Study (BCS70). Participants included all surviving children born in mainland Britain in a single week in April 1970; the analytical sample included those with valid data at age 46-48 (n = 7951; 2016-2018). The main outcome was multimorbidity, which was operationalised as a binary indicator of two or more long-term health conditions where at least one of these conditions was of physical health. It also included symptom complexes (e.g., chronic pain), sensory impairments, and alcohol problems. RESULTS Prevalence of mid-life multimorbidity was 33.8% at age 46-48. Those with fathers from unskilled social occupational class (vs professional) at birth had 43% higher risk of mid-life multimorbidity (risk ratio = 1.43, 95% confidence interval 1.15 to 1.77). After accounting for potential child and family confounding, an additional kilogram of birthweight was associated with 10% reduced risk of multimorbidity (risk ratio = 0.90, 95% confidence interval 0.84 to 0.96); a decrease of one body mass index point at age 10 was associated with 3% lower risk (risk ratio = 1.03, 95% confidence interval 1.01 to 1.05); one standard deviation higher cognitive ability score at age 10 corresponded to 4% lower risk (risk ratio = 0.96, 95% confidence interval 0.91 to 1.00); an increase of one internalising problem at age 16 was equated with 4% higher risk (risk ratio = 1.04, 95% confidence interval 1.00 to 1.08) and of one externalising problem at age 16 with 6% higher risk (risk ratio = 1.06, 1.03 to 1.09). CONCLUSION Prevalence of multimorbidity was high in mid-life (33.8% at age 46-48) in Britain. Potentially modifiable early-life exposures, including early-life social circumstances, cognitive, physical and emotional development, were associated with elevated risk of mid-life multimorbidity.
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Affiliation(s)
- Dawid Gondek
- Centre for Longitudinal Studies (UCL Institute of Education), 55-59 Gordon Square, London, WC1H 0NU, UK.
| | - David Bann
- Centre for Longitudinal Studies (UCL Institute of Education), 55-59 Gordon Square, London, WC1H 0NU, UK
| | - Matt Brown
- Centre for Longitudinal Studies (UCL Institute of Education), 55-59 Gordon Square, London, WC1H 0NU, UK
| | - Mark Hamer
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Alice Sullivan
- Centre for Longitudinal Studies (UCL Institute of Education), 55-59 Gordon Square, London, WC1H 0NU, UK
| | - George B Ploubidis
- Centre for Longitudinal Studies (UCL Institute of Education), 55-59 Gordon Square, London, WC1H 0NU, UK
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Pedron S, Schmaderer K, Murawski M, Schwettmann L. The association between childhood socioeconomic status and adult health behavior: The role of locus of control. SOCIAL SCIENCE RESEARCH 2021; 95:102521. [PMID: 33653585 DOI: 10.1016/j.ssresearch.2020.102521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/20/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
The socioeconomic environment in childhood is a powerful determinant for health behavior in adulthood, subsequently influencing health outcomes. However, the underlying mechanisms are insufficiently understood. This study assesses locus of control (LOC) as a mediator linking childhood socioeconomic status (SES) with health behavior (smoking, regular alcohol consumption, unhealthy diet and low physical activity). Drawing on a representative sample from Germany (SOEP), we investigated these relations using structural equations modelling. Results show that externally oriented LOC explains up to 6% of the relationship between childhood SES and health behavior in adulthood, independently from adult SES. Stratification indicates that these results hold in women but not in men, in younger and middle-aged individuals but not in older ones. Hence, control beliefs play a modest yet significant role in shaping the socioeconomic gradient in health behavior and might have far-reaching consequences on how morbidity and mortality arise and persist across generations.
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Affiliation(s)
- Sara Pedron
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; German Center for Diabetes Research, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany.
| | - Katharina Schmaderer
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Monika Murawski
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; IFT Institut für Therapieforschung, Leopoldstr. 175, 80804, Munich, Germany
| | - Lars Schwettmann
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Department of Economics, Martin Luther University Halle-Wittenberg, Große Steinstraße 73, 06108, Halle (Saale), Germany
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13
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Blodgett JM, Cooper R, Davis DHJ, Kuh D, Hardy R. Bidirectional associations between word memory and one-legged balance performance in mid and later life. Exp Gerontol 2021; 144:111176. [PMID: 33279666 PMCID: PMC7840581 DOI: 10.1016/j.exger.2020.111176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Age-related changes in cognitive and balance capabilities are well-established, as is their correlation with one another. Given limited evidence regarding the directionality of associations, we aimed to explore the direction and potential explanations of associations between word memory and one-legged balance performance in mid-later life. METHODS A total of 3062 participants in the Medical Research Council National Survey of Health and Development, a British birth cohort study, were included. One-legged balance times (eyes closed) were measured at ages 53, 60-64 and 69 years. Word memory was assessed at ages 43, 53, 60-64 and 69 with three 15-item word-recall trials. Autoregressive cross-lagged and dual change score models assessed bidirectional associations between word memory and balance. Random-effects models quantified the extent to which these associations were explained by adjustment for anthropometric, socioeconomic, behavioural and health status indicators. RESULTS Autoregressive cross-lagged and dual change score models suggested a unidirectional association between word memory and subsequent balance performance. In a sex-adjusted random-effects model, 1 standard deviation increase in word memory was associated with 9% (7,12%) higher balance performance at age 53. This association decreased with age (-0.4% /year (-0.6,-0.1%). Education partially attenuated the association, although it remained in the fully-adjusted model (3% (0.1,6%)). CONCLUSIONS There was consistent evidence that word memory is associated with subsequent balance performance but no evidence of the reverse association. Cognitive processing plays an important role in the balance process, with educational attainment providing some contribution. These findings have important implications for understanding cognitive-motor associations and for interventions aimed at improving cognitive and physical capability in the ageing population.
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Affiliation(s)
| | - Rachel Cooper
- Musculoskeletal Science and Sports Medicine Research Centre, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | | | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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14
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Gondek D, Ploubidis GB, Hossin MZ, Gao M, Bann D, Koupil I. Inequality in hospitalization due to non-communicable diseases in Sweden: Age-cohort analysis of the Uppsala Birth Cohort Multigenerational Study. SSM Popul Health 2021; 13:100741. [PMID: 33537404 PMCID: PMC7841359 DOI: 10.1016/j.ssmph.2021.100741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 08/24/2020] [Accepted: 01/18/2021] [Indexed: 11/30/2022] Open
Abstract
We aimed to investigate cohort differences in age trajectories of hospitalization due to non-communicable conditions, and if these varied by paternal socioeconomic position. We used the Uppsala Birth Cohort Multigenerational Study—including virtually complete information on medical diagnoses. Our sample constituted 28,448 individuals (103,262 observations). The outcome was five-year prevalence of hospitalization due to major non-communicable conditions in 1989–2008. The exposures were age (19–91), year-of-birth (1915–1929; 1938–1972), gender (man vs woman), and parental socioeconomic position (low, medium, and high). We used multilevel logit models to examine associations between exposures and the hospitalization outcome. Younger cohorts had a higher prevalence of hospitalization at overlapping ages than those born earlier, with inter-cohort differences emerging from early-adulthood and increasing with age. For instance, at age 40 predicted probability of hospitalization increased across birth-cohorts—from 1.2% (born in 1948-52) to 2.0% (born in 1963-67)—whereas at age 50 it was 2.9% for those born in 1938-42 compared with 4.6% among participants born in 1953-57. Those with medium and low socioeconomic position had 13.0% and 20.0% higher odds of experiencing hospitalization during the observation period, respectively—when age, year-of-birth and gender were accounted for. We found that no progress was made in reducing the socioeconomic inequalities in hospitalization across cohorts born between 1915 and 1972. Hence, more effective policies and interventions are needed to reduce the overall burden of morbidity—particularly among the most vulnerable. What is already known on this subject? The evidence on trends in morbidity in Sweden is mainly cross-sectional and focused on individual conditions. Rates of various indicators of morbidity (e.g. poor mobility, psychological distress, disability) have increased over time. What this study adds. Successively younger birth cohorts had a higher prevalence of hospitalization, with differences emerging in early-adulthood. Those in medium and low parental socioeconomic position (vs high) had 13% and 20% higher odds of hospitalization. No progress was made in reducing the socioeconomic inequalities across cohorts born between 1915 and 1972.
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Affiliation(s)
- Dawid Gondek
- Centre for Longitudinal Studies, UCL Institute of Education, University College London, United Kingdom
| | - George B Ploubidis
- Centre for Longitudinal Studies, UCL Institute of Education, University College London, United Kingdom
| | | | - Menghan Gao
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - David Bann
- Centre for Longitudinal Studies, UCL Institute of Education, University College London, United Kingdom
| | - Ilona Koupil
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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15
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Ploubidis GB, Batty GD, Patalay P, Bann D, Goodman A. Association of Early-Life Mental Health With Biomarkers in Midlife and Premature Mortality: Evidence From the 1958 British Birth Cohort. JAMA Psychiatry 2021; 78:38-46. [PMID: 32997099 PMCID: PMC7527946 DOI: 10.1001/jamapsychiatry.2020.2893] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Importance Early-life mental health is known to be associated with socioeconomic adversity and psychological distress in adulthood, but less is known about potential associations with biomarkers and mortality. Objective To investigate the association between early-life mental health trajectories with biomarkers in midlife and premature mortality. Design, Setting, and Participants This study used data from the British National Child Development Study, a population-based birth cohort. The initial sample of 17 415 individuals consisted of all infants born in Great Britain in a single week in 1958. Analysis began Feburary 2017 and ended May 2020. Main Outcomes and Measures Biomarkers collected at age 44 to 45 years were fibrinogen, C-reactive protein, glycated hemoglobin, high- and low-density lipoprotein cholesterol, forced expiratory volume, blood pressure, and waist-to-hip ratio. Information on all-cause mortality was available up to age 58 years and cause-specific mortality up to age 50 years. Results Biomarkers were analyzed from 9377 participants (age, 44-45 years, 4712 female [50.3%]) and mortality data from 15 067 participants (age, 58 years; 7379 female [49.0%]). A 4-group longitudinal typology of early-life conduct problems and affective symptoms was identified: (1) stable low, (2) teacher-identified adolescent onset, (3) moderate, and (4) stable high. Compared with the stable-low group, the stable-high (B, 2.308; 95% CI, 0.213-4.404) and teacher-identified adolescent-onset (B, 2.114; 95% CI, 0.725-3.503) groups had less favorable levels of fibrinogen in middle age. Effect modification was observed by sex (P < .005) such that compared with the stable-low group, differences in high-density lipoprotein and abdominal obesity were only observed in female individuals. The stable-high and teacher-identified adolescent-onset groups had elevated risk for all-cause mortality (hazard ratio, 1.878; 95% CI, 1.501-2.350 and hazard ratio, 1.412; 95% CI, 1.174-1.698). Psychopathology-associated mortality was higher in both groups but unintentional injuries-associated mortality only in the stable-high group. Conclusions and Relevance Experiencing affective symptoms and conduct problems in childhood and adolescence is associated with less favorable levels of biomarkers 28 years later and elevated risk of premature mortality. These findings, if causal and generalizable to younger cohorts, may imply that effective interventions on early-life mental health have the potential to shift the distribution of risk and improve population health.
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Affiliation(s)
- George B. Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, UCL Institute of Education, University College London, London, England
| | - G. David Batty
- Department of Epidemiology and Public Health, University College London, London, England
- School of Biological and Population Health Sciences, Oregon State University, Corvallis
| | - Praveetha Patalay
- Centre for Longitudinal Studies, Department of Social Science, UCL Institute of Education, University College London, London, England
- MRC Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, University College London, London, England
| | - David Bann
- Centre for Longitudinal Studies, Department of Social Science, UCL Institute of Education, University College London, London, England
| | - Alissa Goodman
- Centre for Longitudinal Studies, Department of Social Science, UCL Institute of Education, University College London, London, England
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16
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Life course socioeconomic position and body composition in adulthood: a systematic review and narrative synthesis. Int J Obes (Lond) 2021; 45:2300-2315. [PMID: 34316000 PMCID: PMC8528709 DOI: 10.1038/s41366-021-00898-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 05/24/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Multiple systematic reviews have investigated the relation between socioeconomic position (SEP) and body mass index (BMI) throughout the life course. However, BMI does not capture quantity and distribution of fat and muscle, which are better indicators of obesity than BMI, and have been independently linked to adverse health outcomes. Less is known about the relation between SEP and body composition, and the literature has not been reviewed. We therefore systematically reviewed the literature on the association between life course SEP and body composition in adulthood. METHODS A protocol was registered on PROSPERO (CRD42019119937), and the review followed PRISMA guidelines. An electronic search of three databases (MEDLINE, Embase Classic + Embase and SPORTDiscus) was conducted. Original studies in the English language were included that examine the association between any recognised measure of SEP at any age and body composition (fat mass, fat-free mass, ratio and distribution) in adulthood, measured using a direct technique, i.e., not an anthropometric measure. A narrative synthesis was conducted. RESULTS A total of 47 papers were included in the final review, none were from low-income countries (LICs). Greater advantage in childhood and adulthood was associated with lower fat levels in high-income countries (HICs). Associations in the opposite direction were found exclusively in middle-income countries (MICs). No studies in MICs reported associations for childhood SEP. For measures of lean mass, the majority of papers reported no association, or greater advantage in adulthood associated with higher lean mass, with little variation between HICs and MICs. Associations in HICs are more often observed in women than men. CONCLUSION The results indicate that fat measures follow similar patterns to those seen for BMI, and that women in HICs are more likely to experience inequalities in both fat and lean measures. Further research in LICs and MICs is needed.
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17
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Asada Y, Grignon M, Hurley J, Kirkland S. Cautionary tails of grip strength in health inequality studies: An analysis from the Canadian longitudinal study on aging. Soc Sci Med 2020; 265:113382. [PMID: 33010636 DOI: 10.1016/j.socscimed.2020.113382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/13/2020] [Accepted: 09/16/2020] [Indexed: 11/19/2022]
Abstract
Self-rated health is widely used in studies of the socioeconomic gradient of health in community-based populations. Its subjectivity may lead to under- or over-estimation of a true underlying socioeconomic gradient and has increased interest in searching for alternative, objective measures of health. Grip strength has emerged as one such alternative for community-based older populations, yet no study has directly assessed the relationship between these two measures and compared their associations with socioeconomic status and health behaviours. Using 26,754 participants aged 45-85 years in the baseline data of the Canadian Longitudinal Study on Aging Comprehensive Cohort, we estimated adjusted-grip strength through indirect standardization using age, sex, height, weight, and their square terms and used ANOVA to assess the variance of adjusted-grip strength within and between each self-rated health category. We ran four separate logistic regression models, examining unhealthy tails (those reporting poor health vs. not and those at the bottom 8th percentile of adjusted-grip strength vs. above) and healthy tails (those reporting excellent health vs. not and those at the top 20th percentile of adjusted-grip strength vs. below). Stronger adjusted-grip strength correlated with better self-rated health, but only 2% of the total variance of adjusted-grip strength was explained by variance between the self-rated health categories. While self-rated health largely showed the expected socioeconomic gradients and positive relationships with health enhancing behaviours, adjusted-grip strength showed no clear, consistent associations with either socioeconomic or health behaviour variables. The results give caution about using grip strength as an objective alternative to self-rated health in studies of social inequalities in health. Empirical approaches demand careful considerations as to which dimensions of health and corresponding measures of health are most relevant to the context being studied.
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Affiliation(s)
- Yukiko Asada
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia, B3H1V7, Canada.
| | - Michel Grignon
- Department of Economics, Department of Health, Aging & Society, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Ontario, L8S4M4, Canada.
| | - Jeremiah Hurley
- Department of Economics, McMaster University, Hamilton, Ontario, L8S4M4, Canada.
| | - Susan Kirkland
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia, B3H1V7, Canada.
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18
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Du W, Ke L, Wang Y, Hua J, Duan W, Barnett AL. The prenatal, postnatal, neonatal, and family environmental risk factors for Developmental Coordination Disorder: A study with a national representative sample. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 104:103699. [PMID: 32623045 DOI: 10.1016/j.ridd.2020.103699] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/27/2020] [Accepted: 05/14/2020] [Indexed: 06/11/2023]
Abstract
Knowledge of obstetric and environmental influences on Developmental Coordination Disorder (DCD) helps provide increased understanding of the mechanisms underlying the disorder. However, the literature to date has not adequately examined the obstetric and environmental risk factors for DCD in a population-based sample. The current study was therefore conducted to explore the prenatal, perinatal, neonatal, and family environmental risk factors for DCD. A total of 2185 children aged 3-10 years from a national representative sample in China were included; the Movement Assessment Battery for Children-2 was used to assess motor function, and a questionnaire was completed by parents. DCD was identified in 156 children according to the DSM-5 criteria. Multilevel logistic regression was used, and comparisons were made between the DCD and non-DCD group. The results confirmed that male sex, BMI score, preterm birth, and some prenatal conditions are significant risk factors for DCD. Parents' education level and one-child status as two significant environmental risk factors for DCD appear largely independent of other risk factors in the Chinese population. This study provides an opportunity to explore the etiology of DCD and suggest potential assessment, monitoring and intervention programs for DCD that could be examined in the future.
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Affiliation(s)
- Wenchong Du
- Department of Psychology, Nottingham Trent University, Burton Street, Nottingham, NG1 1BU, UK.
| | - Li Ke
- Collaborative Innovation Centre of Assessment for Basic Education Quality, Beijing Normal University, China
| | - Yun Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijng Normal University, China
| | - Jing Hua
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Wen Duan
- Collaborative Innovation Centre of Assessment for Basic Education Quality, Beijing Normal University, China
| | - Anna L Barnett
- Department of Psychology, Health and Professional Development, Oxford Brookes University, UK
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19
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Newman AB, Kritchevsky SB, Guralnik JM, Cummings SR, Salive M, Kuchel GA, Schrack J, Morris MC, Weir D, Baccarelli A, Murabito JM, Ben-Shlomo Y, Espeland MA, Kirkland J, Melzer D, Ferrucci L. Accelerating the Search for Interventions Aimed at Expanding the Health Span in Humans: The Role of Epidemiology. J Gerontol A Biol Sci Med Sci 2020; 75:77-86. [PMID: 31722007 DOI: 10.1093/gerona/glz230] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Extensive work in basic and clinical science suggests that biological mechanisms of aging are causally related to the development of disease and disability in late life. Modulation of the biological mechanisms of aging can extend both life span and health span in animal models, but translation to humans has been slow. METHODS Summary of workshop proceedings from the 2018-2019 Epidemiology of Aging Workshop hosted by the Intramural Research Program at the National Institute on Aging. RESULTS Epidemiologic studies play a vital role to progress in this field, particularly in evaluating new risk factors and measures of biologic aging that may influence health span, as well as developing relevant outcome measures that are robust and relevant for older individuals. CONCLUSIONS Appropriately designed epidemiological studies are needed to identify targets for intervention and to inform study design and sample size estimates for future clinical trials designed to promote health span.
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Affiliation(s)
- Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.,Department of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Stephen B Kritchevsky
- Sticht Center for Health Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jack M Guralnik
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Steven R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute San Fransisco, California, Bethesda, Maryland
| | - Marcel Salive
- National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - George A Kuchel
- University of Connecticut Center on Aging, University of Connecticut Health, Farmington, CT, Baltimore, Maryland
| | - Jennifer Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Martha Clare Morris
- Department of Internal Medicine, Rush Medical College, Rush University, Chicago, Illinois
| | - David Weir
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, New York, New York
| | - Andrea Baccarelli
- Department of Environmental Health Sciences, Laboratory of Precision Environmental Biosciences, Columbia University Mailman School of Public Health, New York, New York
| | - Joanne M Murabito
- Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Yoav Ben-Shlomo
- Population Health Sciences, University of Bristol, Bristol, UK.,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Mark A Espeland
- Department of Biostatistics and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - James Kirkland
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, Minnesota
| | - David Melzer
- College of Medicine and Health, University of Exeter, Exeter, UK.,Center on Aging, School of Medicine, University of Connecticut, Farmington, Connecticut
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
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20
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Duchowny KA, Hicken MT, Cawthon PM, Glymour MM, Clarke P. Life course trauma and muscle weakness in older adults by gender and race/ethnicity: Results from the U.S. health and Retirement Study. SSM Popul Health 2020; 11:100587. [PMID: 32490135 PMCID: PMC7260581 DOI: 10.1016/j.ssmph.2020.100587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 04/09/2020] [Accepted: 04/11/2020] [Indexed: 11/03/2022] Open
Abstract
Muscle weakness, as measured by handgrip strength, is a primary determinant of physical functioning and disability. There is a high burden of muscle weakness in the United States with close to 50 percent of older Americans meeting criteria for clinical muscle weakness. While previous racial/ethnic disparities have been documented among older adults, the extent to which lifecourse trauma shapes muscle strength trajectories is unknown. Using U.S. Health and Retirement Study (N = 20,472, Mean Age = 63.8 years) data on grip strength (2006-2014, up to 3 assessments) and retrospectively reported traumatic events, we fit gender-stratified growth curve models to investigate whether traumatic events experienced across the lifecourse or at distinct sensitive periods (childhood, early/emerging adulthood or mid-life) predicted later-life trajectories of grip strength. There was no association between cumulative trauma and trajectories of grip strength and the main effects for the life stage models were largely null. However, among White women, our results suggest that traumatic events experienced during childhood (β = -0.012; 95% CI = -0.024, 0.0004) compared to middle adulthood are associated with faster declines in grip strength in later life. Traumatic events reported during childhood was related to a slower decline in grip strength over time among Hispanic women compared to that for White women (β = 0.086, 95% CI = 0.044, 0.128). Among Black men, the association between traumatic events during early/emerging adulthood and age-related declines in grip strength was stronger for Black men than for White men (interaction β = -0.070; 95% CI = -0.138, 0.001). Traumatic events experienced during distinct life stages may influence later life declines in grip strength and exacerbate racial inequalities in later life. This study addresses an important gap by investigating the life course social determinants of later life muscle strength, which is a key driver of physical functioning and mobility.
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Affiliation(s)
- Kate A Duchowny
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Margaret T Hicken
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Peggy M Cawthon
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.,Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.,Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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21
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Mishra AA, Friedman EM, Mihalec-Adkins BP, Evich CD, Christ SL, Marceau K. Childhood maltreatment exposure and physical functional limitations in late adulthood: examining subjective sleep quality in midlife as a mediator. Psychol Health 2020; 35:573-592. [PMID: 31496306 PMCID: PMC7061057 DOI: 10.1080/08870446.2019.1657576] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 07/19/2019] [Accepted: 08/13/2019] [Indexed: 12/28/2022]
Abstract
Objective: The present study had three major aims: 1) To identify sub-groups of adults with differing combinations of childhood maltreatment exposures, 2) to understand the association of childhood maltreatment sub-group membership with subjective sleep quality in midlife, and 3) to assess poor sleep quality in midlife as a mechanism between childhood maltreatment sub-group membership and physical functional limitations in late adulthood. Design: Data come from the Biomarker project of the Midlife Development in the United States study (n = 1251). Outcome measures: The Pittsburgh Sleep Quality Index (Buysse et al., 1989) was used to assess sleep quality in midlife. Functional limitations in late adulthood were measured using a version of the SF-36 (Brazier et al., 1992). Results: Two vulnerable childhood maltreatment sub-groups emerged (Physical and Emotional Maltreatment Sub-group, n = 49, and Sexual Abuse Sub-group, n = 105) and a normative sub-group (n = 1087; low exposure to childhood maltreatment). Poor sleep quality in midlife mediated the association between both maltreatment sub-groups and functional limitations in late adulthood. Conclusion: Results highlight the role of sleep in linking childhood maltreatment with functional impairments in adulthood and offer a potential target for interventions to improve quality of life in older adults.
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Affiliation(s)
- Aura Ankita Mishra
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
- Public Health Program, Purdue University, West Lafayette, Indianapolis, USA
| | - Elliot M Friedman
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
| | - Brittany P Mihalec-Adkins
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
| | - Carly D Evich
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
- Public Health Program, Purdue University, West Lafayette, Indianapolis, USA
| | - Sharon L Christ
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
- Department of Statistics, Purdue University, West Lafayette, Indianapolis, USA
| | - Kristine Marceau
- Department of Human Development and Family Studies, Purdue University, West Lafayette, Indianapolis, USA
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22
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Blodgett JM, Cooper R, Davis DHJ, Kuh D, Hardy R. Associations Between Factors Across Life and One-Legged Balance Performance in Mid and Later Life: Evidence From a British Birth Cohort Study. Front Sports Act Living 2020; 2020:00028. [PMID: 32395714 PMCID: PMC7212024 DOI: 10.3389/fspor.2020.00028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction: Despite its associations with falls, disability, and mortality, balance is an under-recognized and frequently overlooked aspect of aging. Studies investigating associations between factors across life and balance are limited. Understanding the factors related to balance performance could help identify protective factors and appropriate interventions across the life course. This study aimed to: (i) identify socioeconomic, anthropometric, behavioral, health, and cognitive factors that are associated with one-legged balance performance; and (ii) explore how these associations change with age. Methods: Data came from 3,111 members of the MRC National Survey of Health and Development, a British birth cohort study. Multilevel models examined how one-legged standing balance times (assessed at ages 53, 60–64, and 69) were associated with 15 factors across life: sex, maternal education (4 years), paternal occupation (4 years), own education (26 years), own occupation (53 years), and contemporaneous measures (53, 60–64, 69 years) of height, BMI, physical activity, smoking, diabetes, respiratory symptoms, cardiovascular events, knee pain, depression and verbal memory. Age and sex interactions with each variable were assessed. Results: Men had 18.8% (95%CI: 13.6, 23.9) longer balance times than women at age 53, although this difference decreased with age (11.8% at age 60–64 and 7.6% at age 69). Disadvantaged socioeconomic position in childhood and adulthood, low educational attainment, less healthy behaviors, poor health status, lower cognition, higher body mass index (BMI), and shorter height were associated with poorer balance at all three ages. For example, at age 53, those from the lowest paternal occupational classes had 29.6% (22.2, 38.8) worse balance than those from the highest classes. Associations of balance with socioeconomic indicators, cognition and physical activity became smaller with age, while associations with knee pain and depression became larger. There were no sex differences in these associations. In a combined model, the majority of factors remained associated with balance. Discussion: This study identified numerous risk factors across life that are associated with one-legged balance performance and highlighted diverse patterns of association with age, suggesting that there are opportunities to intervene in early, mid and later life. A multifactorial approach to intervention, at both societal and individual levels, may have more benefit than focusing on a single risk factor.
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Affiliation(s)
- Joanna M Blodgett
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
| | - Daniel H J Davis
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Rebecca Hardy
- CLOSER, Institute of Education, UCL, London, United Kingdom
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Body structure, muscular strength and living conditions of primary school children in Warsaw. J Biosoc Sci 2020; 53:98-107. [PMID: 32077387 DOI: 10.1017/s0021932020000061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of this study was to determine whether the living conditions of school children affects their body structure and muscular strength. Data were taken from 400 girls and 341 boys aged 7-15 years attending nine primary schools in Warsaw in 1997. A questionnaire was completed, anthropological measurements made and two muscular strength tests conducted. The questionnaire asked questions on the children's level of education, their parents' professions and monthly incomes, the number of persons in the family and the number of rooms in the family's apartment/home. Body height, body weight, chest and arm circumferences, grip strength and vertical jump height were measured and used to calculate body mass index, Marty's Index and the Sargent Vertical Jump Index. Statistical tests included Student's t-test, Principal Component Analysis (PCA) and multiple regression analysis. Body height, chest circumference, Sargent Vertical Jump Index and grip strength were significantly greater in the boys than the girls. Two factors, namely 'socioeconomic status' (F1) and 'family size' (F2), describing living conditions, were isolated after PCA. Boys from bigger families (F2) were shorter, with lower weights and BMIs, smaller chest and arm circumferences and greater grip strengths than those from smaller families, whereas girls from families of lower socioeconomic status (F1) weighed less and had greater BMIs and arm circumferences than those from higher socioeconomic status families. The results suggest that boys seem to be more 'ecosensitive' than girls.
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24
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Smith NR, Ferraro KF, Kemp BR, Morton PM, Mustillo SA, Angel JL. Childhood Misfortune and Handgrip Strength Among Black, White, and Hispanic Americans. J Gerontol B Psychol Sci Soc Sci 2020; 74:526-535. [PMID: 27927743 DOI: 10.1093/geronb/gbw147] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 10/28/2016] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Although early-life insults may affect health, few studies use objective physical measures of adult health. This study investigated whether experiencing misfortune during childhood is associated with handgrip strength (HGS) in later life. METHOD Data on childhood misfortune and adult characteristics from the Health and Retirement Study were used to predict baseline and longitudinal change in HGS among White, Black, and Hispanic American men and women. RESULTS Regression analyses revealed that multiple indicators of childhood misfortune were related to HGS at baseline, but the relationships were distinct for men and women. Over the study, having one childhood impairment predicted steeper declines in HGS for men, but childhood misfortune was unrelated to HGS change among women. Hispanic Americans had lower baseline HGS than their non-Hispanic counterparts and manifested steeper declines in HGS. DISCUSSION The relationship between childhood exposures and adult HGS varied by the type of misfortune, but there was no evidence that the relationship varied by race/ethnicity. The significant and enduring Hispanic disadvantage in HGS warrants greater attention in gerontology.
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Affiliation(s)
- Natalie R Smith
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill
| | - Kenneth F Ferraro
- Center on Aging and the Life Course, West Lafayette, Indiana.,Department of Sociology, Purdue University, West Lafayette, Indiana
| | - Blakelee R Kemp
- Center on Aging and the Life Course, West Lafayette, Indiana.,Department of Sociology, Purdue University, West Lafayette, Indiana
| | - Patricia M Morton
- Children's Environmental Health Initiative, Houston, Texas.,Department of Statistics, Houston, Texas.,Department of Sociology, Rice University, Houston, Texas
| | - Sarah A Mustillo
- Department of Sociology, University of Notre Dame, South Bend, Indiana
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25
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Kuh D, Cooper R, Sattar N, Welsh P, Hardy R, Ben-Shlomo Y. Systemic Inflammation and Cardio-Renal Organ Damage Biomarkers in Middle Age Are Associated With Physical Capability Up to 9 Years Later. Circulation 2020; 139:1988-1999. [PMID: 30667283 PMCID: PMC6485301 DOI: 10.1161/circulationaha.118.037332] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Physical capability, a key component of healthy aging, is associated with cardiovascular and other risk factors across life. We investigated whether midlife biomarkers of heart and kidney damage capturing the cumulative impact of long-term adverse exposures were associated with the level and decline in physical capability over 9 years of follow-up, taking account of systemic inflammatory biomarkers and conventional cardiovascular risk factors. Methods: We used data on 1736 men and women from the oldest British birth cohort study with walking speed, chair rise speed, balance time, and grip strength assessed at ages 60 to 64 and 69 years. We tested associations between logged and standardized measures of cystatin C, NT-proBNP (N-terminal pro-B-type natriuretic peptide), interleukin (IL)-6, and E-selectin at age 60 to 64 years with performance at age 69 years, adjusting for sex, height, and body mass index; then for performance at age 60 to 64 years. These biomarkers were mutually adjusted, and additionally adjusted for cardiovascular risk factors (pulse pressure, total/high density lipoprotein cholesterol, glycosylated hemoglobin), diabetes mellitus, cardiovascular and kidney disease, smoking status, and lifetime socioeconomic position. Results: Cystatin C, NT-proBNP, and IL-6 (but not E-selectin) were inversely associated with all outcomes, adjusted for sex, height, and body mass index. For example, a 1-SD increase in logged NT-proBNP was associated with weaker grip (−0.63 kg, 95% CI, −0.99 to −0.28); the equivalent association for cystatin C was −0.60 kg (95% CI, −0.94 to −0.25) and for IL-6 was −0.76 kg (95% CI, −1.11 to −0.41). Most associations remained, albeit attenuated, after adjustment for previous performance and mutual adjustment of the biomarkers. NT-proBNP and IL-6 (but not cystatin C) were more strongly associated with the outcomes than many of the conventional risk factors after mutual adjustment. Conclusions: Higher levels of NT-proBNP may identify those in midlife at risk of accelerated physical decline. Before considering the use of NT-proBNP for risk stratification, further research should untangle whether these associations exist because the biomarker is an integrated measure of cumulative exposures to relevant stressors across life, or whether it is marking additional risk pathways. Randomized trials to reduce the rate of decline in physical capability or delay incident disability could benefit from including middle-aged adults and adding NT-proBNP and IL-6 as intermediate outcomes.
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Affiliation(s)
- Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, UK (D.K., R.C., R.H.)
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing, University College London, UK (D.K., R.C., R.H.)
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, UK (N.S., P.W.)
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, UK (N.S., P.W.)
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing, University College London, UK (D.K., R.C., R.H.)
| | - Yoav Ben-Shlomo
- Population Health Sciences, University of Bristol, UK (Y.B-S.)
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Gilman SE, Huang YT, Jimenez MP, Agha G, Chu SH, Eaton CB, Goldstein RB, Kelsey KT, Buka SL, Loucks EB. Early life disadvantage and adult adiposity: tests of sensitive periods during childhood and behavioural mediation in adulthood. Int J Epidemiol 2020; 48:98-107. [PMID: 30277525 DOI: 10.1093/ije/dyy199] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Early exposure to socioeconomic disadvantage is associated with obesity. Here we investigated how early, and conducted mediation analyses to identify behavioural factors in adulthood that could explain why. METHODS Among 931 participants in the New England Family Study, we investigated the associations of family socioeconomic disadvantage measured before birth and at age 7 years with the following measures of adiposity in mid-adulthood (mean age = 44.4 years): body mass index (BMI), waist circumference and, among 400 participants, body composition from dual-energy X-ray absorption scans. RESULTS In linear regressions adjusting for age, sex, race and childhood BMI Z-score, participants in the highest tertile of socioeconomic disadvantage at birth had 2.6 additional BMI units in adulthood [95% confidence interval (CI) = 1.26, 3.96], 5.62 cm waist circumference (95% CI = 2.69, 8.55), 0.73 kg of android fat mass (95% CI = 0.25, 1.21), and 7.65 higher Fat Mass Index (95% CI = 2.22, 13.09). Conditional on disadvantage at birth, socioeconomic disadvantage at age 7 years was not associated with adult adiposity. In mediation analyses, 10-20% of these associations were explained by educational attainment and 5-10% were explained by depressive symptoms. CONCLUSIONS Infancy may be a sensitive period for exposure to socioeconomic disadvantage, as exposure in the earliest years of life confers a larger risk for overall and central adiposity in mid-adulthood than exposure during childhood. Intervention on these two adult risk factors for adiposity would, if all model assumptions were satisfied, only remediate up to one-fifth of the excess adult adiposity among individuals born into socioeconomically disadvantaged households.
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Affiliation(s)
- Stephen E Gilman
- Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yen-Tsung Huang
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.,Department of Epidemiology.,Department of Biostatistics, Brown School of Public Health, Providence, RI, USA
| | | | - Golareh Agha
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Su H Chu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Risë B Goldstein
- Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Karl T Kelsey
- Department of Epidemiology.,Department of Pathology and Laboratory Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Eric B Loucks
- Department of Epidemiology.,Department of Behavioural and Social Sciences, Brown School of Public Health, Providence, RI, USA.,Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Okamura T, Sugiyama M, Inagaki H, Murayama H, Ura C, Miyamae F, Edahiro A, Motokawa K, Awata S. Anticipatory anxiety about future dementia-related care needs: towards a dementia-friendly community. Psychogeriatrics 2019; 19:539-546. [PMID: 30884068 DOI: 10.1111/psyg.12433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 01/01/2019] [Accepted: 01/22/2019] [Indexed: 11/30/2022]
Abstract
AIM Although a dementia-friendly community is a global goal, community-dwelling persons with dementia continue to have unmet care needs. The aim of this study was to explore the characteristics of persons who experience anxiety about the possibility of not receiving proper dementia care should they need it in the future. METHODS A questionnaire was mailed to all residents aged 65 years or older (n = 132 005) living in one Tokyo district. The questionnaire included an item that measured anxiety about the possibility of not receiving proper dementia care as well as items about sociodemographic variables, depressive symptoms, frailty, housebound status, socioeconomic status, social support, access to a general practitioner (GP), and experience of dementia care. RESULTS Of the 74 171 participants who responded to the anxiety item, 58 481 (78.8%) reported anxiety about the possibility of not receiving proper dementia care should they need it in the future. Simultaneous multiple logistic regression analysis indicated that factors associated with this anticipatory anxiety were depressive symptoms, frailty or prefrailty, being female, not being currently socioeconomically disadvantaged, not having someone who can take you to the hospital when you do not feel well, being younger (65-74 years), being married, not trusting in neighbours, higher educational level (>9 years), not having someone to consult when you are in trouble, not working, having been socioeconomically disadvantaged in childhood, only greeting or less with neighbours, and not having the experience of dementia care. Having access to a GP, living alone, and going out less than once a week did not show a significant association. CONCLUSIONS This large-scale study explored factors associated with anticipatory anxiety about the possibility of not receiving proper dementia care should it be needed in the future. Further studies concerning interventions to decrease such anxiety are needed.
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Affiliation(s)
| | - Mika Sugiyama
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Chiaki Ura
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Fumiko Miyamae
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuich Awata
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Vieira MCA, da Câmara SMA, Moreira MA, Pirkle CM, Vafaei A, Maciel ÁCC. Symptoms of urinary incontinence and pelvic organ prolapse and physical performance in middle-aged women from Northeast Brazil: a cross-sectional study. BMC WOMENS HEALTH 2019; 19:94. [PMID: 31296215 PMCID: PMC6624881 DOI: 10.1186/s12905-019-0786-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/24/2019] [Indexed: 11/30/2022]
Abstract
Background Reproductive history and urogynecological disorders have been associated with limitations in physical function. However, little is known about the relationship between symptoms of urinary incontinence and pelvic organ prolapse, and physical performance. Therefore, the purpose of this study was to examine whether symptoms of urinary incontinence and pelvic organ prolapse are independently associated factors with indicators of lower physical performance in middle-aged women from Northeast Brazil. Methods This is a cross-sectional study of 381 women between 40 to 65 years old living in Parnamirim, Northeast Brazil. Physical performance was assessed by gait speed, chair stand and standing balance tests. Urinary incontinence and pelvic organ prolapse were self-reported. Multiple linear regression analyses were performed to model the effect of self-reported urinary incontinence and pelvic organ prolapse on each physical performance measure, adjusted for covariates (age, family income, education, body mass index, parity). Results In the analysis adjusted for confounders, women reporting urinary incontinence spent, on average, half a second longer to perform the chair stand test (β = 0.505 95% CI: 0.034: 0.976). Those reporting pelvic organ prolapse shortened the balance time with eyes open by 2.5 s on average (β = − 2.556; CI: − 4.769: − 0.343). Conclusions Symptoms of pelvic organ prolapse and urinary incontinence are associated to worse physical performance in middle-aged women. These seemingly small changes in physical performance levels are of clinical importance, since these conditions may influence women’s physical ability, with implications for other tasks important to daily functioning and should be addressed by health policies targeting women’s health and functionality.
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Affiliation(s)
- Mariana Carmem Apolinário Vieira
- Physiotherapy Department of Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524 - Campus Universitário - Lagoa Nova, CEP, Natal, RN, 59072-970, Brazil.
| | - Saionara Maria Aires da Câmara
- Physiotherapy Department of Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524 - Campus Universitário - Lagoa Nova, CEP, Natal, RN, 59072-970, Brazil
| | | | | | | | - Álvaro Campos Cavalcanti Maciel
- Physiotherapy Department of Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524 - Campus Universitário - Lagoa Nova, CEP, Natal, RN, 59072-970, Brazil
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Ocampo-Chaparro JM, Reyes-Ortiz CA, Castro-Flórez X, Gómez F. Frailty in older adults and their association with social determinants of Health. The SABE Colombia Study. Colomb Med (Cali) 2019; 50:89-101. [PMID: 31607766 PMCID: PMC6774581 DOI: 10.25100/cm.v50i2.4121] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: To estimate the prevalence of frailty and evaluate the relationship with the social determinants of health in elderly residents in urban and rural areas of Colombia. Methods: The SABE (Health, Wellbeing, and Aging) Colombia project is a cross-sectional study, carried out in 2014-2015, involving 24,553 men and women aged 60 years and older who live in the community in Colombia. For this analysis, we used data from 4,474 participants included as a subsample with grip strength measurements. The frailty syndrome was diagnosed according to the Fried criteria (weakness, low speed, low physical activity, exhaustion, and weight loss). The independent variables were grouped as (a) biological and genetic flow, (b) lifestyle (adverse conditions in childhood) (c) social networks and community, and (d) socio-economic, cultural and environmental conditions. Multiple logistic and linear regression analyses were used to assess the prognostic value of frailty for the outcomes of interest. Results: The prevalence of frailty was 17.9%. The factors significantly associated with frailty were older age, being women, living in rural areas, having low education, a greater number of medical conditions, insufficient current income, childhood health problems and a poor economic situation in childhood. Conclusion: Our results support the need to include frailty prevention programs, to improve the socioeconomic health conditions of infants to avoid future development of frailty.
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Affiliation(s)
- José M Ocampo-Chaparro
- Universidad del Valle, Facultad de Salud, Departamento Medicina Familiar, Cali, Colombia.,Universidad Libre, Facultad Ciencias de la Salud, Departamento de Medicina Interna, Grupo Interinstitucional de Medicina Interna (GIMI 1), Cali, Colombia
| | - Carlos A Reyes-Ortiz
- The University of Texas at Houston, Department of Internal Medicine McGovern Medical School, Division of Geriatric and Palliative Medicine, Houston Texas, USA.,Florida Agricultural & Mechanical University, Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Tallahassee, Florida, USA
| | - Ximena Castro-Flórez
- Universidad del Valle, Facultad de Salud, Departamento de Medicina Familiar, Escuela de Medicina, Cali, Colombia.,Pontificia Universidad Javeriana, Departamento de Clínicas Médicas, Cali, Colombia
| | - Fernando Gómez
- Universidad de Caldas, Grupo de Investigaciones en Gerontología y Geriatría, Grupo de Epidemiología y Población, Manizales, Colombia
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Murayama H, Sugiyama M, Inagaki H, Edahiro A, Okamura T, Ura C, Miyamae F, Motokawa K, Awata S. Childhood socioeconomic disadvantage as a determinant of late-life physical function in older Japanese people. Arch Gerontol Geriatr 2019; 87:103894. [PMID: 31202585 DOI: 10.1016/j.archger.2019.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/17/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND In this study, we examined the relationship between childhood socioeconomic status and physical function among older Japanese people, and investigated whether there is a sex variation in this association. METHODS We administered a cross-sectional questionnaire survey to all independent community-dwelling individuals ≥65 years old, living in Adachi Ward, Tokyo (N = 132,005). Participants self-reported their physical function using the Motor Fitness Scale, and we divided the scores into quartiles for analysis. Childhood socioeconomic status was retrospectively assessed according to a single item. RESULTS We analyzed 75,358 questionnaires. The average age of participants was 73.8 ± 6.0 years, and 55.0% were women. An ordered logistic regression analysis showed that lower childhood socioeconomic status was associated with lower physical function, independent of adult sociodemographic factors, health behaviors, and health conditions. This association was stronger in women than in men. CONCLUSIONS Our findings indicate that low childhood socioeconomic status might have a long-term influence on physical function in late life and that this influence varies by sex. Assessment of socioeconomic disadvantage in childhood is important for developing strategies to help older people maintain their physical function longer.
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Affiliation(s)
- Hiroshi Murayama
- Institute of Gerontology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan.
| | - Mika Sugiyama
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan, Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan, Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan, Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan, Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Chiaki Ura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan, Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Fumiko Miyamae
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan, Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan, Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Shuichi Awata
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan, Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
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Kuh D, Hardy R, Blodgett JM, Cooper R. Developmental factors associated with decline in grip strength from midlife to old age: a British birth cohort study. BMJ Open 2019; 9:e025755. [PMID: 31072852 PMCID: PMC6528009 DOI: 10.1136/bmjopen-2018-025755] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To test whether developmental factors are associated with grip strength trajectories between 53 and 69 years, and operate independently or on the same pathway/s as adult factors. DESIGN British birth cohort study. SETTING England, Scotland and Wales. PARTICIPANTS 3058 men and women. MAIN OUTCOME MEASURES Grip strength (kg) at ages 53, 60-64 and 69 were analysed using multilevel models to estimate associations with developmental factors (birth weight, growth parameters, motor and cognitive development) and father's social class, and investigate adult factors that could explain observed associations, testing for age and sex interactions. RESULTS In men, heavier birth weight, beginning to walk 'on time', later puberty and greater weight 0-26 years and in women, heavier birth weight and earlier age at first standing were independently associated with stronger grip but not with its decline. The slower decline in grip strength (by 0.07 kg/year, 95% CI 0.02 to 0.11 per 1 SD, p=0.003) in men of higher cognitive ability was attenuated by adjusting for adult verbal memory. CONCLUSIONS Patterns of growth and motor development have persisting associations with grip strength between midlife and old age. The strengthening associations with cognition suggest that, at older ages, grip strength increasingly reflects neural ageing processes. Interventions across life that promote muscle development or maintain muscle strength should increase the chance of an independent old age.
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Affiliation(s)
- Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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Cheval B, Chabert C, Sieber S, Orsholits D, Cooper R, Guessous I, Blane D, Kliegel M, Courvoisier D, Kelly-Irving M, Boisgontier M, Cullati S. Association between Adverse Childhood Experiences and Muscle Strength in Older Age. Gerontology 2019; 65:474-484. [DOI: 10.1159/000494972] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/30/2018] [Indexed: 11/19/2022] Open
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Madathil S, Blaser C, Nicolau B, Richard H, Parent MÉ. Disadvantageous Socioeconomic Position at Specific Life Periods May Contribute to Prostate Cancer Risk and Aggressiveness. Front Oncol 2018; 8:515. [PMID: 30498692 PMCID: PMC6249302 DOI: 10.3389/fonc.2018.00515] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/22/2018] [Indexed: 01/09/2023] Open
Abstract
Background: Previous studies on socioeconomic position (SEP) and risk of prostate cancer (PCa) have produced contradictory results. Most measured SEP only once during the individuals' life span. The aim of the study was to identify life course models that describe best the relationship between SEP measured during childhood/adolescence, early- and late-adulthood, and risk of PCa overall as well as according to tumor aggressiveness at diagnosis. Methods: We used data from a population-based case-control study of PCa conducted in the predominantly French-speaking population in Montreal, Canada. Cases (n = 1,930) with new, histologically-confirmed PCa were ascertained across hospitals deserving the French-speaking population in 2005-2009. Controls (n = 1,991), selected from Quebec's list of French-speaking electors, were frequency-matched to cases (±5 years). In-person interviews collected information on socio-demographic and lifestyle characteristics, and a complete occupational history. Measures of SEP during childhood/adolescence included parents' ownership of a car and father's longest occupation, while the subject's first and longest occupations were used to indicate early- and late-adulthood SEP, respectively. We used the Bayesian relevant life course exposure model to investigate the relationship between lifelong SEP and PCa risk. Results: Cumulative exposure to disadvantageous SEP was associated with about a 50% increase in odds of developing PCa. Late-adulthood SEP was identified as a sensitive period for aggressive PCa. Childhood/adolescence SEP based on parents' ownership of a car was associated with non-aggressive PCa. Associations were independent from PCa screening. Conclusion: Disadvantageous SEP over the life course was associated with higher PCa incidence, with consistent evidence of sensitive time periods for cancer aggressiveness. The mechanisms through which disadvantageous SEP relates to PCa risk need to be further elucidated.
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Affiliation(s)
- Sreenath Madathil
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, Laval, QC, Canada
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Christine Blaser
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, Laval, QC, Canada
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Belinda Nicolau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Hugues Richard
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, Laval, QC, Canada
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, Laval, QC, Canada
- School of Public Health, Université de Montréal, Montreal, QC, Canada
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Gomes CS, Pirkle CM, Barbosa JFS, Vafaei A, Câmara SMA, Guerra RO. Age at First Birth, Parity and History of Hysterectomy Are Associated to Frailty Status: Cross-Sectional Analysis from the International Mobility in Aging Study -Imias. J Cross Cult Gerontol 2018; 33:337-354. [DOI: 10.1007/s10823-018-9360-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Petersen GL, Pedersen JLM, Rod NH, Mortensen EL, Kawachi I, Osler M, Hansen ÅM, Lund R. Childhood socioeconomic position and physical capability in late-middle age in two birth cohorts from the Copenhagen aging and midlife biobank. PLoS One 2018; 13:e0205019. [PMID: 30273400 PMCID: PMC6166988 DOI: 10.1371/journal.pone.0205019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 09/18/2018] [Indexed: 02/03/2023] Open
Abstract
This study examines the association between childhood socioeconomic position and objective physical capability including new functional measures of potential relevance to a population in late-middle age. The study population covers two Danish birth cohorts followed-up in the Copenhagen Aging and Midlife Biobank (age 48–58 years, 2009–2011, N = 4,204). Results from linear regression models revealed that being born in higher socioeconomic position was associated with higher jump height: Paternal occupational class four = 0.19 cm (95% confidence interval (CI): -0.44, 0.82), three = 0.59 cm (95% CI: -0.02, 1.19), two = 1.29 cm (95% CI: 0.64, 1.94), and one = 1.29 cm (95% CI: 0.45, 2.13) (reference = five); medium parental social class = 0.88 cm (95% CI: 0.03, 1.72) and high = 1.79 cm (95% CI: 0.94, 2.63) (reference = low). Higher childhood socioeconomic position was also associated with better chair rise performance and hand grip strength, while among women it was related to reduced flexibility: Medium parental social class = -1.31 cm (95% CI: -3.05, 0.42) and high = -2.20 cm (95% CI: -3.94, -0.47) (reference = low); unwed mother = 1.75 cm (95% CI: 0.36, 3.14) (reference = married). Overall, the findings suggest that higher childhood socioeconomic position is primarily related to moderately better scores in the most strenuous physical capability measures and hand grip strength among healthy adults in late-middle age.
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Affiliation(s)
- Gitte Lindved Petersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Jolene Lee Masters Pedersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- Unit of Medical Psychology, Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States of America
| | - Merete Osler
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Frederiksberg, Denmark
| | - Åse Marie Hansen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Rikke Lund
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
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The influence of lifecourse financial strains on the later-life health of the Japanese as assessed by four models based on different health indicators. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractIn this study, four models used for assessing the influence of lifecourse financial strains on later-life health (the latent period effects, pathway, social mobility and accumulative effects models) were tested in the context of Japan by using different types of health indicators: comorbidity, disabled activities of daily living, disabled cognitive function, self-rated health and depressive symptoms. We hypothesised that suitable models for describing the influence of financial strain would differ according to the type of health indicator used. Participants aged 60–92 years (N = 2,500) were obtained in 2012 by using a two-stage stratified random sampling method. The final number of participants in the sample was 1,324. The results indicate that three models – pathway, accumulative effects and social mobility – describe the influence of a person's lifecourse financial strain on comorbidity, cognitive function, self-rated health and depressive symptoms. In turn, the latent period effects model explains the influence of lifecourse financial strain on comorbidity. However, only the pathway model described the influence of lifecourse financial strain on activities of daily living. These results suggest that disadvantages in lifecourse socio-economic status influence the decline of health in elderly Japanese people, similar to people in Western countries. However, the finding that suitable models for describing the influence of socio-economic status on health will differ according to the type of health indicator is an original contribution of this study.
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Age, socioeconomic patterns and regional variations in grip strength among older adults (50+) in India: Evidence from WHO’s Study on Global Ageing and Adult Health (SAGE). Arch Gerontol Geriatr 2018; 76:100-105. [DOI: 10.1016/j.archger.2018.02.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/07/2018] [Accepted: 02/08/2018] [Indexed: 12/31/2022]
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Lübs L, Peplies J, Drell C, Bammann K. Cross-sectional and longitudinal factors influencing physical activity of 65 to 75-year-olds: a pan European cohort study based on the survey of health, ageing and retirement in Europe (SHARE). BMC Geriatr 2018; 18:94. [PMID: 29661154 PMCID: PMC5902922 DOI: 10.1186/s12877-018-0781-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 04/03/2018] [Indexed: 11/10/2022] Open
Abstract
Background The promotion of physical activity (PA) plays a major role for healthy ageing even in older age. There is a lack of cross-sectional and longitudinal studies explicitly dealing with barriers and drivers to PA in older adults. Therefore the aims of this study are a) to determine the prevalence of insufficient physical activity (IPA) in 65 to 75-year-olds in Europe and to identify factors associated with IPA in cross-section and b) to identify longitudinal risk factors for IPA in prior active persons. Methods This study is using data of the Survey of Health, Ageing and Retirement in Europe (SHARE). SHARE is a cross-national panel database including individual data of the non-institutionalised population aged 50+ from 27 European countries. For the present paper, we included a cohort that participated in all first four waves of SHARE (2004–2011) aged 65-to-75–years at wave four (male n = 1761, female n = 2085) from 10 European countries. To identify cross-sectional and longitudinal associations, we calculated prevalence odds ratios and hazard ratios with 95% confidence intervals. Results The prevalence of IPA in 65–75-year-olds varied widely between countries, ranging from 55.4% to 83.3% in women and from 46.6% to 73.7% in men. IPA was associated with several intrapersonal factors and strength of association was similar for men and women for almost all investigated factors. Statistically significant associated with IPA were socioeconomic factors as low educational level (own and parental) and financial difficulties (male: POR: 1.60: 95%-CI: 1.26–2.03; female: POR: 1.58; 95%-CI: 1.26–1.97) and health-related factors as e.g. number of chronic diseases (male: POR: 1.34: 95%-CI: 1.23–1.45; female: POR: 1.31; 95%-CI: 1.21–1.42). Interpersonal only the size of social network was associated with IPA (male and female: POR: 0.88, 95%-CI: 0.81–0.95). Longitudinally in a fully adjusted model, only grip strength (HR: 0.99; CI-95%: 0.98–0.99) and BMI (HR: 1.02; CI-95%: 1.00–1.04) were statistically significant risk factors for IPA. Conclusions PA promotion programs for older adults should incorporate the heterogeneity of health status and physical condition that can typically occur in this age group. Electronic supplementary material The online version of this article (10.1186/s12877-018-0781-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lena Lübs
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany.
| | - Jenny Peplies
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Carina Drell
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Karin Bammann
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
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Stringhini S, Carmeli C, Jokela M, Avendaño M, McCrory C, d'Errico A, Bochud M, Barros H, Costa G, Chadeau-Hyam M, Delpierre C, Gandini M, Fraga S, Goldberg M, Giles GG, Lassale C, Kenny RA, Kelly-Irving M, Paccaud F, Layte R, Muennig P, Marmot MG, Ribeiro AI, Severi G, Steptoe A, Shipley MJ, Zins M, Mackenbach JP, Vineis P, Kivimäki M. Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study. BMJ 2018; 360:k1046. [PMID: 29572376 PMCID: PMC5865179 DOI: 10.1136/bmj.k1046] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess the association of low socioeconomic status and risk factors for non-communicable diseases (diabetes, high alcohol intake, high blood pressure, obesity, physical inactivity, smoking) with loss of physical functioning at older ages. DESIGN Multi-cohort population based study. SETTING 37 cohort studies from 24 countries in Europe, the United States, Latin America, Africa, and Asia, 1990-2017. PARTICIPANTS 109 107 men and women aged 45-90 years. MAIN OUTCOME MEASURE Physical functioning assessed using the walking speed test, a valid index of overall functional capacity. Years of functioning lost was computed as a metric to quantify the difference in walking speed between those exposed and unexposed to low socioeconomic status and risk factors. RESULTS According to mixed model estimations, men aged 60 and of low socioeconomic status had the same walking speed as men aged 66.6 of high socioeconomic status (years of functioning lost 6.6 years, 95% confidence interval 5.0 to 9.4). The years of functioning lost for women were 4.6 (3.6 to 6.2). In men and women, respectively, 5.7 (4.4 to 8.1) and 5.4 (4.3 to 7.3) years of functioning were lost by age 60 due to insufficient physical activity, 5.1 (3.9 to 7.0) and 7.5 (6.1 to 9.5) due to obesity, 2.3 (1.6 to 3.4) and 3.0 (2.3 to 4.0) due to hypertension, 5.6 (4.2 to 8.0) and 6.3 (4.9 to 8.4) due to diabetes, and 3.0 (2.2 to 4.3) and 0.7 (0.1 to 1.5) due to tobacco use. In analyses restricted to high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was 8.0 (5.7 to 13.1) for men and 5.4 (4.0 to 8.0) for women, whereas in low and middle income countries it was 2.6 (0.2 to 6.8) for men and 2.7 (1.0 to 5.5) for women. Within high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was greater in the United States than in Europe. Physical functioning continued to decline as a function of unfavourable risk factors between ages 60 and 85. Years of functioning lost were greater than years of life lost due to low socioeconomic status and non-communicable disease risk factors. CONCLUSIONS The independent association between socioeconomic status and physical functioning in old age is comparable in strength and consistency with those for established non-communicable disease risk factors. The results of this study suggest that tackling all these risk factors might substantially increase life years spent in good physical functioning.
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Affiliation(s)
- Silvia Stringhini
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Biopôle 2-Route de la Corniche 10, 1010 Switzerland
| | - Cristian Carmeli
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Biopôle 2-Route de la Corniche 10, 1010 Switzerland
| | - Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Mauricio Avendaño
- Department of Global Health and Social Medicine, King's College London, London, UK
- Harvard T.H. Chan School of Public Health, Boston MA, USA
| | - Cathal McCrory
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Angelo d'Errico
- Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco (TO), Italy
| | - Murielle Bochud
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Biopôle 2-Route de la Corniche 10, 1010 Switzerland
| | - Henrique Barros
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Giuseppe Costa
- Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco (TO), Italy
| | - Marc Chadeau-Hyam
- MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Cyrille Delpierre
- INSERM, UMR1027, Toulouse, France, and Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Martina Gandini
- Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco (TO), Italy
| | - Silvia Fraga
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Marcel Goldberg
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France, and Paris Descartes University, Paris, France
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Camille Lassale
- University College London, Department of Epidemiology and Public Health, London, UK
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Michelle Kelly-Irving
- INSERM, UMR1027, Toulouse, France, and Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Fred Paccaud
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Biopôle 2-Route de la Corniche 10, 1010 Switzerland
| | - Richard Layte
- Department of Sociology, Trinity College Dublin, Dublin, Ireland
| | - Peter Muennig
- Global Research Analytics for Population Health, Health Policy and Management, Columbia University, New York, NY, USA
| | - Michael G Marmot
- University College London, Department of Epidemiology and Public Health, London, UK
| | - Ana Isabel Ribeiro
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Gianluca Severi
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia
- CESP, Inserm U1018, Université Paris-Saclay, Villejuif, France
- Human Genetics Foundation (HuGeF), Turin, Italy
| | - Andrew Steptoe
- University College London, Department of Epidemiology and Public Health, London, UK
| | - Martin J Shipley
- University College London, Department of Epidemiology and Public Health, London, UK
| | - Marie Zins
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France, and Paris Descartes University, Paris, France
| | - Johan P Mackenbach
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, School of Public Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Mika Kivimäki
- University College London, Department of Epidemiology and Public Health, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Finland
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Carney C, Benzeval M. Social patterning in grip strength and in its association with age; a cross sectional analysis using the UK Household Longitudinal Study (UKHLS). BMC Public Health 2018; 18:385. [PMID: 29562880 PMCID: PMC5863489 DOI: 10.1186/s12889-018-5316-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/14/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Grip strength in early adulthood and midlife is an important predictor of disability, morbidity and mortality in later life. Understanding social patterning in grip strength at different life stages could improve insight into inequalities in age-related decline and when in the life course interventions could prevent the emergence of inequalities. METHODS Using United Kingdom Household Longitudinal Study (UKHLS) data on 19,292 people aged 16 to 99, fractional polynomial models were fitted to identify which function of age best described its association with grip strength. Linear regressions were used to establish whether socio-economic position (SEP), as measured by maternal education, highest educational qualification and income, was associated with grip strength. To test whether the association between age and grip strength was modified by SEP, interactions between SEP and the age terms were added. Differentiation was used to identify the age at which grip strength was highest for men and women and predicted levels of grip strength at peak were compared. RESULTS SEP is significantly associated with grip strength on all SEP measures, except education for men. Grip strength is highest at a younger age, and less strong for all measures of disadvantage for women and most measures for men. Interaction terms were not statistically significant indicating that the association between age and grip strength was not modified by SEP. Grip strength peak was 29.3 kg at age 33 for women with disadvantaged childhood SEP compared with 30.2 kg at age 35 for women with advantaged childhood SEP. CONCLUSION The SEP differences in age and level of peak grip strength could be indicative of decline in muscle strength beginning earlier and from a lower base for disadvantaged groups. This could impact on the capacity for healthy ageing for those with disadvantaged SEP.
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Affiliation(s)
- Caroline Carney
- Department of Health Policy, Cowdray House, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Michaela Benzeval
- Institute for Social and Economic Research (ISER), University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK
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Caleyachetty R, Hardy R, Cooper R, Richards M, Howe LD, Anderson E, Kuh D, Stafford M. Modeling Exposure to Multiple Childhood Social Risk Factors and Physical Capability and Common Affective Symptoms in Later Life. J Aging Health 2018; 30:386-407. [PMID: 28553793 PMCID: PMC5915301 DOI: 10.1177/0898264316680434] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study presents three approaches, that is, cumulative risk, factor analysis, and latent class analysis, to summarize exposure to multiple childhood social risk factors and to compare their utility when examining associations with physical capability and common affective symptoms in adults aged 60 to 64 years. METHODS Data came from the U.K. Medical Research Council (MRC) National Survey of Health and Development, with prospective childhood social risk factor data collected in 1950 to 1957 and retrospectively in 1989. Physical capability and common affective symptom data were collected in 2006 to 2011. RESULTS The cumulative risk approach and factor analysis provided evidence that children who were exposed to multiple social risk factors had lower levels of physical capability and more symptoms of common affective symptoms in later life. DISCUSSION The cumulative social risk approach and the use of factor analysis to identify contexts of social risk, may offer viable methods for linking multiple childhood social risk exposure to aging outcomes.
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Affiliation(s)
- Rishi Caleyachetty
- MRC Unit for Lifelong Health and Ageing, University College London, UK
- Institute of Applied Health Research, University of Birmingham, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Laura D. Howe
- MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - Emma Anderson
- MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Mai Stafford
- MRC Unit for Lifelong Health and Ageing, University College London, UK
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Marshall NA, Marusak HA, Sala-Hamrick KJ, Crespo LM, Rabinak CA, Thomason ME. Socioeconomic disadvantage and altered corticostriatal circuitry in urban youth. Hum Brain Mapp 2018; 39:1982-1994. [PMID: 29359526 DOI: 10.1002/hbm.23978] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/04/2018] [Accepted: 01/08/2018] [Indexed: 12/13/2022] Open
Abstract
Socioeconomic disadvantage (SED) experienced in early life is linked to a range of risk behaviors and diseases. Neuroimaging research indicates that this association is mediated by functional changes in corticostriatal reward systems that modulate goal-directed behavior, reward evaluation, and affective processing. Existing research has focused largely on adults and within-household measures as an index of SED, despite evidence that broader community-level SED (e.g., neighborhood poverty levels) has significant and sometimes distinct effects on development and health outcomes. Here, we test effects of both household- and community-level SED on resting-state functional connectivity (rsFC) of the ventral striatum (VS) in 100 racially and economically diverse children and adolescents (ages 6-17). We observed unique effects of household income and community SED on VS circuitry such that higher community SED was associated with reduced rsFC between the VS and an anterior region of the medial prefrontal cortex (mPFC), whereas lower household income was associated with increased rsFC between the VS and the cerebellum, inferior temporal lobe, and lateral prefrontal cortex. Lower VS-mPFC rsFC was also associated with higher self-reported anxiety symptomology, and rsFC mediated the link between community SED and anxiety. These results indicate unique effects of community-level SED on corticostriatal reward circuitry that can be detected in early life, which carries implications for future interventions and targeted therapies. In addition, our findings raise intriguing questions about the distinct pathways through which specific sources of SED can affect brain and emotional development.
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Affiliation(s)
- Narcis A Marshall
- Department of Psychology, University of Southern California, Los Angeles, California
| | - Hilary A Marusak
- Department of Pharmacy Practice, Wayne State University School of Medicine, Detroit, Michigan
| | - Kelsey J Sala-Hamrick
- Department of Psychology, University of Southern California, Los Angeles, California.,Department of Psychology, Wayne State University, Detroit, Michigan
| | - Laura M Crespo
- Department of Psychology, University of Southern California, Los Angeles, California.,Department of Psychology, Wayne State University, Detroit, Michigan
| | - Christine A Rabinak
- Department of Pharmacy Practice, Wayne State University School of Medicine, Detroit, Michigan
| | - Moriah E Thomason
- Department of Pediatrics Wayne State University School of Medicine, Detroit, Michigan.,Merrill Palmer Skillman Institute for Child and Family Development Wayne State University, Detroit, Michigan.,Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, Bethesda, Maryland
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Syddall HE, Westbury LD, Shaw SC, Dennison EM, Cooper C, Gale CR. Correlates of Level and Loss of Grip Strength in Later Life: Findings from the English Longitudinal Study of Ageing and the Hertfordshire Cohort Study. Calcif Tissue Int 2018; 102:53-63. [PMID: 29058059 PMCID: PMC5760591 DOI: 10.1007/s00223-017-0337-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/03/2017] [Indexed: 12/17/2022]
Abstract
Characterisation of grip strength (GS) using isometric dynamometry is central to the definition of sarcopenia. Determinants of low GS include: older age, shorter stature, low physical activity, poor nutrition, socioeconomic disadvantage and multimorbidity. Less is known about risk factors for accelerated loss of GS. We investigated determinants of level and 8-year loss of GS in 3703 men and women (aged 52-82 years) in the English Longitudinal Study of Ageing (ELSA). Four hundred and forty-one men and women (aged 59-71 years) who participated in a 10-year follow-up of the Hertfordshire Cohort Study (HCS) were used for replication. Variables were harmonised between cohorts. Change in GS was characterised using mixed-effects models in ELSA and a residual change approach in HCS and analysed for men and women combined. Men in ELSA and HCS had higher average levels of GS at baseline, and accelerated rates of loss, compared with women. In ELSA, older age, shorter stature and multimorbidity were correlated with lower level, and accelerated rate of loss, of GS in both sexes (accelerated loss of 0.04 (95% CI 0.00-0.08) standard deviation scores per additional morbidity after multivariable adjustment). Socioeconomic disadvantage, low level of physical activity and poorer self-reported health were also correlated with low GS level, but not loss rate, after multivariable adjustment. Analysis in HCS yielded similar results. Our results identify multimorbidity as a modifiable determinant of loss of muscle strength in later life, and raise the possibility that developmental influences may impact on rate of involutional decline in muscle strength.
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Affiliation(s)
- H E Syddall
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - L D Westbury
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - S C Shaw
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
- Victoria University of Wellington, Wellington, New Zealand
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
| | - C R Gale
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
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Archer G, Pinto Pereira S, Power C. Child maltreatment as a predictor of adult physical functioning in a prospective British birth cohort. BMJ Open 2017; 7:e017900. [PMID: 29079607 PMCID: PMC5665268 DOI: 10.1136/bmjopen-2017-017900] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/05/2017] [Accepted: 09/28/2017] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Child maltreatment (abuse and neglect) has established associations with mental health; however, little is known about its relationship with physical functioning. Physical functioning (ie, the ability to perform the physical tasks of daily living) in adulthood is an important outcome to consider, as it is strongly associated with an individual's ability to work, and future disability and dependency. We aimed to establish whether maltreatment was associated with physical functioning, independent of other early-life factors. SETTING 1958 British birth cohort. PARTICIPANTS 8150 males and females with data on abuse and who participated at age 50 years. OUTCOME MEASURES The primary outcome was poor physical functioning at 50 years (<65 on the Short-Form 36 survey physical functioning subscale). Secondary outcomes included mental health and self-reported health at 50 years. RESULTS 23% of participants reported at least one type of maltreatment; 12% were identified with poor physical functioning. Neglect (ORadj 1.55, 95% CI 1.24 to 1.93), psychological abuse (ORadj 1.49, 1.17-1.88) and sexual abuse (ORadj 2.56, 1.66-3.96) were associated with poor physical functioning independent of other maltreatments and covariates, including childhood social class, birth weight and childhood illness. Odds of poor physical functioning increased with multiple types of maltreatment (ptrend <0.001); ORadj ranged from 1.49 (1.23-1.82) for a single type to 2.09 (1.53-2.87) for those reporting > 3 types of maltreatment, compared with those with none. Associations of similar magnitude were observed for mental and self-reported health outcomes. CONCLUSIONS Child neglect, psychological and sexual abuse were associated with poor physical functioning at 50 years, with accumulating risk for those with multiple types of maltreatment. Associations were independent of numerous early-life factors and were comparable in magnitude to those observed for mental health and self-rated health. Prevention or alleviation of the ill effects of maltreatment could be an effective policy intervention to promote healthy ageing.
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Affiliation(s)
- Gemma Archer
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Snehal Pinto Pereira
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Christine Power
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Physical fitness and anthropometric characteristics among adolescents living in urban or rural areas of Kosovo. BMC Public Health 2017; 17:711. [PMID: 28915864 PMCID: PMC5602925 DOI: 10.1186/s12889-017-4727-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 09/08/2017] [Indexed: 12/26/2022] Open
Abstract
Background High physical fitness levels in childhood and adolescence are associated with positive health-related outcomes later in life. Albeit many researchers investigated rural-urban differences in physical fitness, the outcomes of these studies are inconsistent and data on Kosovo are widely missing. Thus, this study aims to examine anthropometric and physical fitness parameters in 14 to 15 year old Kosovan adolescents living in rural and urban areas. Methods Two schools from Pristina (mostly urban population) and two schools in the surrounding villages of the district of Deçan (mostly rural population) were selected. Anthropometric and physical fitness parameters were determined from a total of 354 adolescents (216 urban: 14.5 ± 0.4 years, 138 rural: age 14.5 ± 0.4 years) who volunteered to participate in this cross-sectional study performed in 2013/14. Results The prevalence of overweight and obesity was 18.9% in girls and 28.2% in males and excess body fat was detected in 18.2% of the girls and 15.9% of the boys with no differences between rural and urban adolescents. Rural adolescents performed slightly better in relative handgrip strength (+4.7%, p = 0.032) and running speed (10 m: +2.2%, p = 0.012; 20 m: +1.9%, p = 0.035), but no other differences were detected in standing long jump, counter movement jump, cardiorespiratory fitness and sit and reach test. A multinomial logistic regression analysis revealed that being a female was associated with a lower relative risk for overweight (RR = 0.11, 95% CI: 0.03–0.34, p < 0.001) and high body fat content (RR = 0.20, 95% CI: 0.05–0.56, p < 0.001). In addition, higher handgrip strength, longer sprinting time and lower aerobic fitness were associated with a higher relative risk for overweight and excess body fat. In contrast, lower handgrip strength increased the risk for experiencing thinness (RR = 0.92, 95% CI: 0.89–0.96, p < 0.001). Conclusions It could be shown that there is a high prevalence of overweight and obesity, especially in 14 to 15 year old boys in Kosovo which does not differ between rural and urban areas. Worse physical performance is associated with a higher risk for overweight and obesity highlighting the importance for interventions in this area and for starting longitudinal observations of a secular trend. Electronic supplementary material The online version of this article (10.1186/s12889-017-4727-4) contains supplementary material, which is available to authorized users.
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Zhong Y, Wang J, Nicholas S. Gender, childhood and adult socioeconomic inequalities in functional disability among Chinese older adults. Int J Equity Health 2017; 16:165. [PMID: 28865465 PMCID: PMC5581446 DOI: 10.1186/s12939-017-0662-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 08/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gender difference and life-course socioeconomic inequalities in functional disability may exist among older adults. However, the association is less well understood among Chinese older population. The objective is to provide empirical evidences on this issue by exploring the association between gender, childhood and adult socioeconomic inequalities in functional disability. METHODS Data from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS) was utilized. Functional disability was assessed by the activities of daily living (ADL) and instrumental activities of daily living (IADL). Childhood socioeconomic status (SES) was measured by birthplace, father's education and occupation. Adult SES was measured in terms of education and household income. Multivariate logistic regressions were conducted to assess the association between gender, childhood and adult SES and functional disability. RESULTS Based on a sample of 18,448 older adults aged 45 years old and above, our results showed that the prevalence of ADL and IADL disability was higher among women than men, but gender difference disappeared after adult SES and adult health were controlled. Harsh conditions during childhood were associated with functional disability but in multivariate analyses only father's education was associated with IADL disability (OR for no education = 1.198; 95% CI = 1.062-1.353). Current SES such as higher education and good economic situation are protective factors of functional disability. CONCLUSIONS Childhood and adult SES were both related to functional disability among older adults. Our findings highlight the need for policies and programs aimed at decreasing social inequalities during childhood and early adulthood, which could reduce socioeconomic inequalities in functional disability in later life.
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Affiliation(s)
- Yaqin Zhong
- School of Public Health, Nantong University, 9 Seyuan Road, Nantong, 210029 Jiangsu People’s Republic of China
| | - Jian Wang
- School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012 Shandong People’s Republic of China
| | - Stephen Nicholas
- School of Management and School of Commerce, Tianjin Normal University, West Bin Shui Avenue, Tianjin, 300074 People’s Republic of China
- Guangdong Research Institute for International Strategies, Guangdong University of Foreign Studies, 2 Baiyun North Avenue, Baiyun, Guangzhou, Guangdong, 510420 People’s Republic of China
- School of International Business, Beijing Foreign Studies University, 19 North Xisanhuan Avenue, Haidian, Beijing, 100089 People’s Republic of China
- University of Newcastle, Newcastle, NSW 2308 Australia
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Anderson EL, Heron J, Ben-Shlomo Y, Kuh D, Cooper R, Lawlor DA, Fraser A, Howe LD. Adversity in childhood and measures of aging in midlife: Findings from a cohort of british women. Psychol Aging 2017; 32:521-530. [PMID: 28891666 PMCID: PMC5592847 DOI: 10.1037/pag0000182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Very few studies have assessed whether socioeconomic and psychosocial adversity during childhood are associated with objective measures of aging later in life. We assessed associations of socioeconomic position (SEP) and total psychosocial adversity during childhood, with objectively measured cognitive and physical capability in women during midlife. Adverse childhood experiences were retrospectively reported at mean ages 28-30 years in women from the Avon Longitudinal Study of Parents And Children (N = 2,221). We investigated associations of childhood SEP and total psychosocial adversity, with composite measures of cognitive and physical capability at mean age 51 years. There was evidence that, compared with participants whose fathers had professional occupations, participants whose fathers had managerial/technical, skilled nonmanual, skilled manual, and partly or unskilled manual occupations had, on average, lower physical and cognitive capability. There was a clear trend for increasing magnitudes of association with lowering childhood SEP. There was also evidence that greater total psychosocial adversity in childhood was associated with lower physical capability. Total psychosocial adversity in childhood was not associated with cognitive capability. Lower SEP in childhood is detrimental to cognitive and physical capability in midlife, at least in part, independently of subsequent SEP in adulthood. Greater psychosocial adversity in childhood is associated with poorer physical capability, independently of social disadvantage in childhood. Our findings highlight the need for interventions to both identify and support children experiencing socioeconomic or psychosocial of adversity as early as possible. (PsycINFO Database Record
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Affiliation(s)
- Emma L Anderson
- Medical Research Council Integrative Epidemiology Unit, University of Bristol
| | - Jon Heron
- School of Social and Community Medicine, University of Bristol
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol
| | - Diana Kuh
- Medical Research Council Unit for Lifelong Health and Ageing, University College London
| | - Rachel Cooper
- Medical Research Council Unit for Lifelong Health and Ageing, University College London
| | - Debbie A Lawlor
- Medical Research Council Integrative Epidemiology Unit, University of Bristol
| | - Abigail Fraser
- Medical Research Council Integrative Epidemiology Unit, University of Bristol
| | - Laura D Howe
- School of Social and Community Medicine, University of Bristol
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Lee Y. Early-Life Socioeconomic Conditions, Height, and Functional Health Status in Later Life: Evidence From South Korea. Asia Pac J Public Health 2017; 29:475-484. [PMID: 28774181 DOI: 10.1177/1010539517723708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The article contributes to the literature on health inequalities by examining the associations between early-life socioeconomic status (SES), height, and functional limitations in later life among Korean men and women. The findings were based on 1562 men and 1801 women aged 50 to 79 years who participated in the 2005 Korean Labor and Income Panel Study (KLIPS). Among men, 17.8% reported having functional limitations, compared to 31.8% among women. The ordered logistic regression analyses showed that for Korean men, the relative contribution of early-life SES to functional health was less important than that of adult SES. For Korean women, childhood SES was a significant predictor of functional limitations after controlling for attained SES. Short stature was associated with poorer functional health only among men and the relationship was explained by adult characteristics. The results imply that long-term effect of childhood deprivation on health may be stronger among women in Korean society.
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Affiliation(s)
- Yeonjin Lee
- 1 National University of Singapore, Asia Research Institute, Singapore
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49
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Weinstein G. Childhood conditions and current physical performance among non-institutionalized individuals aged 50+ in Israel. Eur J Ageing 2017; 13:335-347. [PMID: 28190995 DOI: 10.1007/s10433-016-0380-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Adverse socioeconomic conditions in childhood have been previously linked with high risk of various health conditions. However, the association with future physical function has been less studied. Hand grip strength and chair-rising time are objective measures of physical capability indicating current and future health outcomes. The aim of this study was to test the hypothesis that perceived socio-economic status in childhood is related to current measures of physical function, among Israeli participants of the Survey of Health, Ageing and Retirement in Europe project. The study included 2300 participants aged 50 years or older (mean age 68 ± 10; 56 % women). Generalized linear regression models were used to examine the associations of childhood wealth and number of books in residence with grip strength and time to complete five rises from a chair. Logistic regression models were used to assess the relationships between the early life conditions and the ability to perform the physical tests. Adjustment was made for current income or household wealth, and for demographic, anthropometric, health, and life-style measures. Being wealthy and having a large number of books at home in childhood was associated with a stronger hand grip and a better chair-rise test performance. These associations were more robust in women compared to men, and persisted after adjustment for potential covariates. In addition, childhood wealth and number of books were associated with lower risk of being unable to perform the tests. Thus, early-life programming may contribute to physical function indicators in mid- and late-life.
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Affiliation(s)
- Galit Weinstein
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, Haifa, Israel
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50
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Multidimensional predictors of physical frailty in older people: identifying how and for whom they exert their effects. Biogerontology 2017; 18:237-252. [PMID: 28160113 PMCID: PMC5350240 DOI: 10.1007/s10522-017-9677-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/10/2017] [Indexed: 12/15/2022]
Abstract
Physical frailty in older people is an escalating health and social challenge. We investigate its physical, psychological, and social predictors, including how and for whom these conditions exert their effects. For 4638 respondents aged 65–89 years from wave 2 of the English Longitudinal Study of Ageing, we examine prediction of future physical frailty by physical, psychological, and social conditions using latent growth curve analysis with multiple indicators. In addition, we explore their indirect effects through disease and physiologic decline, and repeat these analyses after stratification by gender, age group, and selected conditions which are possible moderators. We find that chronic disease, allostatic load, low physical activity, depressive symptoms, cognitive impairment, and poor social support all predict future physical frailty. Furthermore, chronic disease and allostatic load mediate the effects of low physical activity, depressive symptoms, and cognitive impairment on future physical frailty. Finally, although poor social integration is not a predictor of future physical frailty, this condition moderates the indirect effect of poor social support through chronic disease by rendering it stronger. By virtue of their roles as predictor, mediator, or moderator on pathways to physical frailty, chronic disease, allostatic load, low physical activity, cognitive impairment, depressive symptoms, poor social support, and poor social integration are potentially modifiable target conditions for population-level health and social interventions to reduce future physical frailty in older people.
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