Economic hardship over twenty-two consecutive years of adult life and markers of early ageing: physical capability, cognitive function and inflammation

Abstract

This study assesses the associations between annual measures of economic hardship (EH) across 22 years of adulthood and objective measures of early ageing in a Danish late-middle-aged population (N = 5575). EH (years < 60% of the National median equivalized household disposable income) was experienced by 18% during 1987–2008. Four or more years in EH (reference = null years in EH) was related to poorer physical capability (chair rise: − 1.49 counts/30 s [95% confidence interval (CI) − 2.36, − 0.61], hand grip strength: − 1.22 kg [95% CI − 2.38, − 0.07], jump height: − 1.67 cm [95% CI − 2.44, − 0.91] and balance: 18% [95% CI 9, 28]), poorer cognitive function (Intelligenz-Struktur-Test: − 1.50 points [95% CI − 2.89, − 0.12]) and higher inflammatory levels (C-reactive protein: 22% [95% CI 4, 44], and Interleukin-6: 23% [95% CI 10, 39]). Comparing four EH trajectories, people with a high versus low probability of EH over time had poorer physical capability (chair rise: − 1.70 counts/30 s [95% CI − 3.38, − 0.01], grip: − 4.33 kg [95% CI − 6.50, − 2.16], jump: − 1.68 cm [95% CI − 3.12, − 0.25] and balance: 31% [95% CI 12, 52]). No associations were observed with tumour necrosis factor-α. Results were adjusted for sex, age, long-term parental unemployment/financial problems, education, baseline income and cohort. This study suggested EH for four or more years to be associated with poorer physical capability, cognitive function and increased inflammatory levels in midlife. High probability of EH across adulthood was similarly related to poorer physical capability and CRP, but not cognitive function and the remaining inflammatory markers. In conclusion, preventive initiatives focusing on reducing the burden of sustained economic hardship may lead to increased healthy ageing.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Ahnquist J, Fredlund P, Wamala SP (2007) Is cumulative exposure to economic hardships more harzardous to women’s health than men’s? a 16-year follow-up study of the Swedish survey of living conditions. J Epidemiol Community Heal 61:331–336. https://doi.org/10.1136/jech.2006.049395

    Article  Google Scholar 

  2. Al Hazzouri AZ, Elfassy T, Sidney S et al (2017) Sustained economic hardship and cognitive function: the coronary artery risk development in young adults study. Am J Prev Med 52:1–9. https://doi.org/10.1016/j.amepre.2016.08.009

    Article  Google Scholar 

  3. Amthauer R, Brocke B, Liepmann D, Beauducel A (2001) Intelligenz-Struktur-Test 2000 R. Hogrefe Verlag, Göttingen

    Google Scholar 

  4. Avlund K, Damsgaard MT, Osler M (2004) Social position and functional decline among non-disabled old men and women. Eur J Public Health 14:212–216

    Article  Google Scholar 

  5. Avlund K, Osler M, Mortensen EL et al (2014) Copenhagen aging and midlife biobank (CAMB): an introduction. J Aging Health 26:5–20. https://doi.org/10.1177/0898264313509277

    Article  Google Scholar 

  6. Baadsgaard M, Quitzau J (2011) Danish registers on personal income and transfer payments. Scand J Public Health 39:103–105. https://doi.org/10.1177/1403494811405098

    Article  Google Scholar 

  7. Ben-Shlomo Y, Cooper R, Kuh D (2016) The last two decades of life course epidemiology, and its relevance for research on ageing. Int J Epidemiol 45:973–988. https://doi.org/10.1093/ije/dyw096

    Article  Google Scholar 

  8. Boen C, Yang YC (2016) The physiological impacts of wealth shocks in late life: evidence from the great recession. Soc Sci Med 150:221–230. https://doi.org/10.1016/j.socscimed.2015.12.029

    Article  Google Scholar 

  9. Cevenini E, Monti D, Franceschi C (2013) Inflamm-ageing. Curr Opin Clin Nutr Metab Care 16:14–20. https://doi.org/10.1097/MCO.0b013e32835ada13

    Article  Google Scholar 

  10. Cooper R, Kuh D, Hardy R et al (2010) Objectively measured physical capability levels and mortality: systematic review and meta-analysis. BMJ 341:c4467. https://doi.org/10.1136/bmj.c4467

    Article  Google Scholar 

  11. Cooper R, Kuh D, Cooper C et al (2011) Objective measures of physical capability and subsequent health: a systematic review. Age Ageing 40:14–23. https://doi.org/10.1093/ageing/afq117

    Article  Google Scholar 

  12. Cooper R, Hardy R, Sayer AA, Kuh D (2014a) A life course approach to physical capability. In: Kuh D, Cooper R, Hardy R et al (eds) A life course approach to healthy ageing, First. Oxford University Press, Oxford, pp 16–31

    Google Scholar 

  13. Cooper R, Stafford M, Hardy R et al (2014b) Physical capability and subsequent positive mental wellbeing in older people: findings from five HALCyon cohorts. Age (Omaha) 36:445–456. https://doi.org/10.1007/s11357-013-9553-8

    Article  Google Scholar 

  14. Eurostat - Statistics Explained (2014) Glossary:At-risk-of-poverty rate. http://ec.europa.eu/eurostat/statistics-explained/index.php/Glossary:At-risk-of-poverty_rate. Accessed 23 Mar 2018

  15. Fairfax A, Balnave R, Adams R (1995) Variability of grip strength during isometric contraction. Ergonomics 38:1819–1830

    Article  Google Scholar 

  16. Galobardes B, Shaw M, Lawlor DA et al (2006) Indicators of socioeconomic position (part 1). J Epidemiol Community Health 60:7–12. https://doi.org/10.1136/jech.2004.023531

    Article  Google Scholar 

  17. Glymour MM, Greenland S (2008) Causal diagrams. In: Rothman KJ, Greenland S, Lash TL (eds) Modern epidemiology. Lippincott Williams & Wilkins, Philadelphia, pp 183–210

    Google Scholar 

  18. Hallqvist J, Lynch J, Bartley M et al (2004) Can we disentangle life course processes of accumulation, critical period and social mobility? an analysis of disadvantaged socio-economic positions and myocardial infarction in the Stockholm heart epidemiology program. Soc Sci Med 58:1555–1562. https://doi.org/10.1016/S0277-9536(03)00344-7

    Article  Google Scholar 

  19. Harper S (2014) Economic and social implications of aging societies. Science (80-) 346:587–591. https://doi.org/10.1126/science.1254405

    Article  Google Scholar 

  20. Hessel P, Avendano M, Hayward M et al (2016) Economic downturns during the life-course and late-life health: an analysis of 11 European countries. Eur J Public Health 41:87–107. https://doi.org/10.1093/eurpub/ckw063

    Article  Google Scholar 

  21. Holsgaard Larsen A, Caserotti P, Puggaard L, Aagaard P (2007) Reproducibility and relationship of single-joint strength vs multi-joint strength and power in aging individuals. Scand J Med Sci Sport 17:43–53. https://doi.org/10.1111/j.1600-0838.2006.00560.x

    Article  Google Scholar 

  22. Hurst L, Stafford M, Cooper R et al (2013) Lifetime socioeconomic inequalities in physical and cognitive aging. Am J Public Health 103:1641–1648. https://doi.org/10.2105/AJPH.2013.301240

    Article  Google Scholar 

  23. Jensen VM, Rasmussen AW (2011) Danish education registers. Scand J Public Health 39:91–94. https://doi.org/10.1177/1403494810394715

    Article  Google Scholar 

  24. Johnson TV, Abbasi A, Master VA (2013) Systematic review of the evidence of a relationship between chronic psychosocial stress and C-reactive protein. Mol Diagn Ther 17:147–164. https://doi.org/10.1007/s40291-013-0026-7

    Article  Google Scholar 

  25. Jones BL, Nagin DS (2007) Advances in group-based trajectory modeling and an SAS procedure for estimating them. Sociol Methods Res 35:542–571. https://doi.org/10.1177/0049124106292364

    Article  Google Scholar 

  26. Jones BL, Nagin DS (2013) A Note on a stata plugin for estimating group-based trajectory models. Sociol Methods Res 42:608–613. https://doi.org/10.1177/0049124113503141

    Article  Google Scholar 

  27. Kahn JR, Pearlin LI (2006) Financial strain over the life course and health among older adults. J Health Soc Behav 47:17–31. https://doi.org/10.1177/002214650604700102

    Article  Google Scholar 

  28. Krieger N, Williams DR, Moss NE (1997) Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health 18:341–378. https://doi.org/10.1146/annurev.publhealth.18.1.341

    Article  Google Scholar 

  29. Kubzansky LD, Seeman TE, Glymour MM (2014) Biological pathways linking social conditions and health - Plausible mechanisms and emerging puzzles. In: Berkman LF, Kawachi I, Glymour MM (eds) Social epidemiology, 2nd edn. Oxford University Press, New York, pp 512–561

    Google Scholar 

  30. Lash T, Fox M, Fink A (2009) Applying quantitative bias analysis to epidemiologic data. Springer Science & Business Media, Berlin

    Google Scholar 

  31. Lund R, Mortensen EL, Christensen U et al (2016) Cohort profile: the Copenhagen aging and midlife biobank (CAMB). Int J Epidemiol 45:1044–1053. https://doi.org/10.1093/ije/dyv149

    Article  Google Scholar 

  32. Lynch J, Kaplan G, Shema S (1997) Cumulative impact of sustained economic hardship on physical, cognitive, psychological and social functioning. N Engl J Med 337:1889–1895. https://doi.org/10.1056/nejm199712253372606

    Article  Google Scholar 

  33. Mortensen EL, Flensborg-Madsen T, Molbo D et al (2014) The relationship between cognitive ability and demographic factors in late midlife. J Aging Health 26:37–53. https://doi.org/10.1177/0898264313508780

    Article  Google Scholar 

  34. Nazmi A, Victora CG (2007) Socioeconomic and racial/ethnic differentials of C-reactive protein levels: a systematic review of population-based studies. BMC Public Health 7:1–12. https://doi.org/10.1186/1471-2458-7-212

    Article  Google Scholar 

  35. Oakes JM, Andrade KE (2017) The measurement of socioeconomic status. In: Oakes JM, Kaufman JS (eds) Methods in social epidemiology, 2nd edn. Jossey-Bass a Wiley Brand, San Francisco, pp 23–42

    Google Scholar 

  36. OECD (2018) Poverty rate (indicator). https://data.oecd.org/inequality/poverty-rate.htm. Accessed 28 Mar 2018

  37. Perna L, Wahl HW, Mons U et al (2015) Cognitive impairment, all-cause and cause-specific mortality among non-demented older adults. Age Ageing 44:445–451. https://doi.org/10.1093/ageing/afu188

    Article  Google Scholar 

  38. Richards M, Deary IJ (2014) A life course approach to cognitive capability. In: Kuh D, Cooper R, Hardy R et al (eds) A life course approach to healthy ageing, First. Oxford University Press, Oxford, pp 32–45

    Google Scholar 

  39. Ritchie C, Trost SG, Brown W, Armit C (2005) Reliability and validity of physical fitness field tests for adults aged 55 to 70 years. J Sci Med Sport 8:61–70. https://doi.org/10.1016/S1440-2440(05)80025-8

    Article  Google Scholar 

  40. Simons RL, Kit M, Beach SRH et al (2016) Economic hardship and biological weathering: the epigenetics of aging in a U. S. sample of black women. Soc Sci Med 150:192–200. https://doi.org/10.1016/j.socscimed.2015.12.001

    Article  Google Scholar 

  41. Strand BH, Cooper R, Hardy R et al (2011) Lifelong socioeconomic position and physical performance in midlife: results from the British 1946 birth cohort. Eur J Epidemiol 26:475–483. https://doi.org/10.1007/s10654-011-9562-9

    Article  Google Scholar 

  42. UCLA Institute for Digital Research and Education (2016) FAQ How do I interpret a regression model when some variables are log transformed? In: UCLA Inst. Digit. Res. Educ. https://stats.idre.ucla.edu/sas/faq/how-can-i-interpret-log-transformed-variables-in-terms-of-percent-change-in-linear-regression/. Accessed 1 Jun 2018

  43. Western B, Bloome D, Sosnaud B, Tach L (2012) Economic Insecurity and Social Stratification. Annu Rev Sociol 38:341–359. https://doi.org/10.1146/annurev-soc-071811-145434

    Article  Google Scholar 

  44. Willson AE, Shuey KM (2016) Life course pathways of economic hardship and mobility and midlife trajectories of health. J Health Soc Behav 57:407–422. https://doi.org/10.1177/0022146516660345

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank the staff at Department of Public Health and National Research Centre for the Working Environment, who undertook the data collection. Further thanks to Kirsten Avlund†, Nils-Erik Fiehn, Åse Marie Hansen, Poul Holm-Pedersen and Merete Osler who participated in the initiation and establishment of the Copenhagen Ageing and Midlife Biobank from 2009 to 2011. The authors acknowledge the crucial role of the initiators and steering groups of The Metropolit Cohort, The Copenhagen Perinatal Cohort and The Danish Longitudinal Study in Work, Unemployment and Health. Further, the authors would like to thank the Social Inequalities in Ageing (SIA) project, funded by NordForsk, Project No. 74637, for valuable collaboration relating to this project.

Funding

This work was funded by the Center for Healthy Aging established by a grant from the Nordea Foundation. The research leading to these results was carried out as part of the Social Inequalities in Ageing (SIA) project, funded by NordForsk, Project No. 74637. The Copenhagen Ageing and Midlife Biobank has been supported by a generous grant from the VELUX FOUNDATIONS (VELUX26145 and 31539).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Else Foverskov.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Responsible editor: Susanne Iwarsson.

Else Foverskov and Gitte Lindved Petersen are co-first authors.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 52 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Foverskov, E., Petersen, G.L., Pedersen, J.L.M. et al. Economic hardship over twenty-two consecutive years of adult life and markers of early ageing: physical capability, cognitive function and inflammation. Eur J Ageing 17, 55–67 (2020). https://doi.org/10.1007/s10433-019-00523-z

Download citation

Keywords

  • Economic hardship
  • Early ageing
  • Life course
  • Physical capability
  • Cognitive function
  • Inflammation