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Childhood Socioeconomic Position and Objectively Measured Physical Capability Levels in Adulthood: A Systematic Review and Meta-Analysis

Birnie, K; Cooper, R; Martin, RM; Kuh, D; Sayer, AA; Alvarado, BE; Bayer, A; ... HALCyon Study Team; + view all (2011) Childhood Socioeconomic Position and Objectively Measured Physical Capability Levels in Adulthood: A Systematic Review and Meta-Analysis. PLOS ONE , 6 (1) , Article e15564. 10.1371/journal.pone.0015564. Green open access

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Background: Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.Methods and Findings: Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.Conclusions: Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.

Type: Article
Title: Childhood Socioeconomic Position and Objectively Measured Physical Capability Levels in Adulthood: A Systematic Review and Meta-Analysis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0015564
Publisher version: http://dx.doi.org/10.1371/journal.pone.0015564
Language: English
Additional information: © 2011 Birnie et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. KB is funded by a Research into Ageing PhD studentship (grant reference: 302). RC is receiving support from the HALCyon programme funded by the New Dynamics of Ageing (RES-353-25-0001). DK and RH are supported by the United Kingdom Medical Research Council. The Caerphilly Prospective Study was undertaken by the former MRC Epidemiology Unit (South Wales), and the Department of Social Medicine, University of Bristol, acts as the data custodian. The Boyd Orr cohort has received funding from the Medical Research Council, the World Cancer Research Fund, Research into Ageing, United Kingdom Survivors, the Economic and Social Research Council, the Wellcome Trust, and the British Heart Foundation. The Aberdeen Birth Cohort 1936 data collection was funded by the Biological Sciences Research Council (wave 1), the Alzheimer Research Trust and a career development award to LJW by the Wellcome Trust. The LBC1921 data were collected by grants from the Biotechnology and Biological Sciences Research Council (wave 1), a Royal Society-Wolfson Research Merit Award to IJD (wave 2), and the Chief Scientist Office of the Scottish Government (wave 3). The LBC1936 data were collected by a Research into Ageing programme grant; this research continues as part of the Help the Aged-funded Disconnected Mind project. The work was undertaken within The University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology, part of the cross council Lifelong Health and Wellbeing Initiative (G0700704/84698). Funding from the BBSRC, EPSRC, ESRC and MRC is gratefully acknowledged. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1298697
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