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

Published online by Cambridge University Press:  13 June 2023

A. Henriques Open the ORCID record for A. Henriques [Opens in a new window] ,
L. Ruano ,
S. Fraga ,
S. Soares ,
H. Barros  and
M. Talih
A. Henriques*
Affiliation:
EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
L. Ruano
Affiliation:
EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal Serviço de Neurologia, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
S. Fraga
Affiliation:
EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
S. Soares
Affiliation:
EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
H. Barros
Affiliation:
EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
M. Talih
Affiliation:
EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
*
Corresponding author: A. Henriques; Email: ana.henriques@ispup.up.pt
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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: β = −9.75; 95% CI: −14.34; −5.15; SF-36 mental health: β = −7.33; 95% CI: −11.55; −3.11; handgrip strength: β = −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 healthlife-course socio-economic factorsolder adults
Type
Research Article
Information
Journal of Biosocial Science , Volume 56 , Issue 1 , January 2024 , pp. 36 - 49
Copyright
© The Author(s), 2023. Published by Cambridge University Press

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