Life-course socio-economic status and its impact on functional health of Portuguese older adults

Autores da FMUP

• José Henrique Dias Pinto De Barros

  Autor

Participantes de fora da FMUP

• Henriques, A
• Ruano, L.
• Fraga, S.
• Soares, S
• Talih, M

Unidades de investigação

• Ciências da Saúde Pública e Forenses, e Educação Médica

Abstract

Functional health is arguably one of the most important health indicators for older adults, because it assesses physical, cognitive and social functions in combination. However, life-course circumstances may impact this multidimensional construct. The aim of the present study was to assess the relationship between life-course socio-economic status (SES) and different dimensions of functional health in older adults. Data on 821 Portuguese adults aged 50 years and over in 2013-2015 were analysed. Life-course SES was computed using participants paternal occupation (non-manual (nm); manual (m)) and own occupation (nm; m), resulting in four patterns: stable high (nm + nm), upward (m + nm), downward (nm + m) and stable low (m + m). Functional health included physical and mental functioning, cognitive function, handgrip strength, and walking speed. Linear (beta coefficients) and logistic regressions (odds ratios) were used to estimate the association between life-course SES and functional health.Overall, those who accumulated social disadvantage during life-course presented worse functional health than those with stable high SES (stable low - SF-36 physical functioning: beta = -9.75; 95% CI: -14.34; -5.15; SF-36 mental health: beta = -7.33; 95% CI: -11.55; -3.11; handgrip strength: beta = -1.60; 95% CI: -2.86; -0.35; walking time, highest tertile: OR = 5.28; 95% CI: 3.07; 9.09). Those with an upward SES were not statistically different from those in the stable high SES for most of the health outcomes; however, those with an upward SES trajectory tended to have higher odds of cognitive impairment (OR = 1.75; 95% CI: 0.96; 3.19). A downward SES trajectory increased the odds of slower walking speed (OR = 4.62; 95% CI: 1.78; 11.95). A disadvantaged life-course SES impacts older adults physical and mental functioning. For some outcomes, this was attenuated by a favourable adulthood SES but those with a stable low SES consistently presented worse functional health.

Keywords

• functional health; life-course socio-economic factors; older adults