Income, education tied to physical function in old age

(Reuters Health) - People with lower socioeconomic status may have fewer years of good physical functioning in old age than their more affluent, educated counterparts, a recent study suggests.

Researchers examined data on socioeconomic status, chronic medical problems, and walking speed – a proxy for physical functioning – for 109,000 adults ages 45 to 90 from 24 countries in Europe, the U.S., Latin America, Africa and Asia. Socioeconomic status includes income, education and occupation and offers a snapshot of how class shapes opportunities within a given society.

At age 60, men of low socioeconomic status had the same walking speed as 67-year-old men with high socioeconomic status, meaning the poorer and less educated people had almost seven fewer years of good physical functioning, the study found.

Women at age 60, meanwhile, lost more than five years of good physical functioning when they had low socioeconomic status, compared to their more affluent counterparts.

“The impact of poor socioeconomic conditions on functioning is comparable to that of major risk factors such as smoking or physical inactivity,” said lead study author Silvia Stringhini of the Institute of Social and Preventive Medicine at Lausanne University Hospital and Lausanne University in Switzerland.

Plenty of previous research has linked poverty, a lack of education and limited job prospects to an increased risk of chronic disease and premature death, researchers note in the BMJ. Along the way, many people experience a decline in physical functioning, which is thought to be caused by the combination of limited resources and complex medical problems.

The current study builds on this thesis by showing that in addition to any chronic health problems that may hasten physical decline, socioeconomic status is an independent risk factor for worsening function. This means some poor people who are otherwise healthy may still have an increased risk of losing physical function.

Men and women of low socioeconomic status, for example, lost more than five years of physical functioning to a lack of exercise, the study found. They also lost five to seven years of good functioning due to obesity, and about six years from diabetes.

The study wasn’t a controlled experiment designed to prove whether or how socioeconomic status might directly impact health or physical functioning.

Even so, the results suggest that doctors and policy makers should focus on socioeconomic status as a risk factor for premature aging, the authors conclude.

Efforts to promote disability-free aging will take on heightened importance as the global population ages, particularly because improvements in healthy aging haven’t kept pace with gains in life expectancy, said Dr. Rachel Cooper, author of an accompanying editorial and a researcher at the University College London in the UK.

“Socioeconomic adversity is, alongside other risk factors, an important target in global efforts to extend disability-free life expectancy,” Cooper said by email. “These new findings provide further empirical evidence in support of renewed calls for action to address global increases in socioeconomic inequality as a matter of urgency for the benefit of the health and wellbeing of our ageing global population.”

SOURCE: and BMJ, online March 23, 2018.