Associations of Childhood Socioeconomic Position with Frailty Trajectories at Older Age

Poor socioeconomic circumstances during childhood have been shown to be associated with negative health outcomes at older age. Frailty is an important outcome associated with ageing, but research on risk factors of frailty is lacking. We aimed to assess associations of childhood socioeconomic position (CSP) with frailty trajectories at older age. Data on well-being, health, socioeconomic situation, and retrospective life course from 17,916 individuals aged 50 years and over included in the longitudinal Survey of Health, Ageing, and Retirement in Europe study was used. Frailty, including pre-frailty, was operationalized as presenting either weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted multilevel logistic regression models were used to analyze associations of CSP with frailty trajectories. Results showed that disadvantaged CSP was associated with higher risk of (pre)frailty and that this association was mediated by education for both men and women (OR=1.45, p<0.01; OR=1.43, p<0.01, respectively). A lower level of education was associated with a lower risk of (pre)frailty (OR=0.97, p<0.001, both men and women). Also lower skill main occupation class was associated with an increased risk of (pre)frailty in both men and women (OR=1.20, p<0.01; OR=1.28, p<0.001, respectively). Moreover, health behaviors and demographics seemed to increase the risk of being (pre)frail. The findings suggest that CSP is associated with frailty trajectories at older age, which can be explained by adult socioeconomic position, in particular by education. The results can help in improving frailty trajectories by stimulating educational achievement and associated consequences across the life course.