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Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study

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Title: Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study
Authors: Stringhini, S
Carmeli, C
Jokela, M
Avendano, M
McCrory, C
D'Errico, A
Bochud, M
Barros, H
Costa, G
Chadeau-Hyam, M
Delpierre, C
Gandini, M
Fraga, S
Goldberg, M
Giles, GG
Lassale, C
Kenny, RA
Kelly-Irving, M
Paccaud, F
Layte, R
Muennig, P
Marmot, MG
Ribeiro, AI
Severi, G
Steptoe, A
Shipley, MJ
Zins, M
Mackenbach, JP
Vineis, P
Kivimaki, M
Item Type: Journal Article
Abstract: Objective: To assess the association of low socioeconomic status and risk factors for non-communicable diseases (diabetes, high alcohol intake, high blood pressure, obesity, physical inactivity, smoking) with loss of physical functioning at older ages. Design: Multi-cohort population based study. Setting: 37 cohort studies from 24 countries in Europe, the United States, Latin America, Africa, and Asia, 1990-2017. Participants: 109 107 men and women aged 45-90 years. Main outcome measure: Physical functioning assessed using the walking speed test, a valid index of overall functional capacity. Years of functioning lost was computed as a metric to quantify the difference in walking speed between those exposed and unexposed to low socioeconomic status and risk factors. Results: According to mixed model estimations, men aged 60 and of low socioeconomic status had the same walking speed as men aged 66.6 of high socioeconomic status (years of functioning lost 6.6 years, 95% confidence interval 5.0 to 9.4). The years of functioning lost for women were 4.6 (3.6 to 6.2). In men and women, respectively, 5.7 (4.4 to 8.1) and 5.4 (4.3 to 7.3) years of functioning were lost by age 60 due to insufficient physical activity, 5.1 (3.9 to 7.0) and 7.5 (6.1 to 9.5) due to obesity, 2.3 (1.6 to 3.4) and 3.0 (2.3 to 4.0) due to hypertension, 5.6 (4.2 to 8.0) and 6.3 (4.9 to 8.4) due to diabetes, and 3.0 (2.2 to 4.3) and 0.7 (0.1 to 1.5) due to tobacco use. In analyses restricted to high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was 8.0 (5.7 to 13.1) for men and 5.4 (4.0 to 8.0) for women, whereas in low and middle income countries it was 2.6 (0.2 to 6.8) for men and 2.7 (1.0 to 5.5) for women. Within high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was greater in the United States than in Europe. Physical functioning continued to decline as a function of unfavourable risk factors between ages 60 and 85. Years of functioning lost were greater than years of life lost due to low socioeconomic status and non-communicable disease risk factors. Conclusions: The independent association between socioeconomic status and physical functioning in old age is comparable in strength and consistency with those for established non-communicable disease risk factors. The results of this study suggest that tackling all these risk factors might substantially increase life years spent in good physical functioning.
Issue Date: 23-Mar-2018
Date of Acceptance: 20-Feb-2018
URI: http://hdl.handle.net/10044/1/58540
DOI: https://dx.doi.org/10.1136/bmj.k1046
ISSN: 0959-8138
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ: British Medical Journal
Volume: 360
Copyright Statement: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: Commission of the European Communities
Funder's Grant Number: 633666
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
GAIT SPEED
PHYSICAL-ACTIVITY
WHITEHALL II
ELDERLY-PEOPLE
UNITED-STATES
MORTALITY
MIDLIFE
LIFE
AGE
ASSOCIATION
Aged
Aging
Alcoholism
Diabetes Mellitus
Female
Humans
Hypertension
Male
Middle Aged
Obesity
Risk Factors
Sedentary Lifestyle
Smoking
Social Class
Walking Speed
Publication Status: Published
Article Number: ARTN k1046
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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