4.6 Article

Association of Life-Course Neighborhood Deprivation With Frailty and Frailty Progression From Ages 70 to 82 Years in the Lothian Birth Cohort 1936

期刊

AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 191, 期 11, 页码 1856-1866

出版社

OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwac134

关键词

aging; frailty; life-course approach; neighborhood deprivation; structured life-course modeling

资金

  1. Economic and Social Research Council, United Kingdom [ES/T003669/1]
  2. US National Institutes of Health [R01AG054628]
  3. University of Edinburgh
  4. NHS Research Scotland through the Edinburgh Clinical Research Facility
  5. Sir Henry Dale Fellowship - Wellcome Trust [221890/Z/20/Z]
  6. Sir Henry Dale Fellowship - Royal Society [221890/Z/20/Z]
  7. Age UK (The Disconnected Mind program grant)
  8. Wellcome Trust [221890/Z/20/Z] Funding Source: Wellcome Trust

向作者/读者索取更多资源

This study investigates the impact of neighborhood social deprivation (NSD) on frailty among older adults, and finds that greater accumulated NSD is associated with higher baseline frailty in males, while higher NSD in the mid- to late adulthood period is associated with widening frailty trajectories in females. This is the first investigation of the life-course impact of NSD on frailty in a cohort of older adults.
Neighborhood features have been postulated to be key predictors of frailty. However, evidence is mainly limited to cross-sectional studies without indication of long-term impact. We explored how neighborhood social deprivation (NSD) across the life course is associated with frailty and frailty progression among older Scottish adults. Participants (n = 323) were persons selected from the Lothian Birth Cohort 1936 with historical measures of NSD in childhood (1936-1955), young adulthood (1956-1975), and mid- to late adulthood (1976-2014). Frailty was measured 5 times between the ages of 70 and 82 years using the Frailty Index. Confounder-adjusted life-course models were assessed using a structured modeling approach; associations were estimated for frailty at baseline using linear regression and for frailty progression using linear mixed-effects models. Accumulation was the most appropriate life-course model for males; greater accumulated NSD was associated with higher frailty at baseline (b = 0.017, 95% confidence interval: 0.005, 0.029). Among females, the mid- to late adulthood sensitive period was the best-fitting life-course model, and higher NSD in this period was associated with widening frailty trajectories (b = 0.005, 95% confidence interval: 0.0004, 0.009). To our knowledge, this is the first investigation of the life-course impact of NSD on frailty in a cohort of older adults. Policies designed to address deprivation and inequalities across the full life course may support healthy aging.

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