Can Social Mobility Impact Frailty Trajectories of Chinese Adults in Later Life? A Nationwide Longitudinal Study.

IF 4.9 3区医学 Q1 GERIATRICS & GERONTOLOGY

Innovation in Aging Pub Date : 2024-01-27 eCollection Date: 2024-01-01 DOI:10.1093/geroni/igae003

Yujia Guo, Fan Yang

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引用次数: 0

Abstract

Background and objectives: Evidence remains unclear on the impact of life-course socioeconomic position (SEP) mobility on frailty trajectories in later life. We aim to examine the longitudinal effects of social mobility on frailty trajectories among Chinese middle-aged and older populations.

Research design and methods: A total of 13 239 participants aged 45 and older from the 2011-2018 China Health and Retirement Longitudinal Study were analyzed. Based on changes in SEP from childhood to adulthood, 5 patterns of social mobility were established. A 32-item deficit cumulative frailty index (FI) was developed to evaluate frailty trajectories at each follow-up. Linear mixed-effects models were used to examine the longitudinal association of the 5 social mobility patterns with the frailty trajectory.

Results: The trajectory of late-life FI increased across all 5 social mobility groups during the follow-up. The FI trajectory had the largest disparity between stable high SEP and stable low SEP, with a faster increase in FI of 0.489 (95% confidence interval [CI]: 0.327-0.650, p < .001) in the stable low versus stable high SEP group. The FI trajectories of individuals in the upward and downward mobility groups fall between those in the stable high SEP and low SEP groups. Specifically, compared to the stable high SEP group, the increase in FI was 0.229 (95% CI: 0.098-0.360, p = .001) faster in the downward mobility group, and 0.145 (95% CI: 0.017-0.273, p = .03) faster in the upward mobility group. The impact of social mobility on frailty trajectories was more pronounced among middle-aged adults and women.

Discussion and implications: These findings emphasize that policies to identify vulnerable populations and reduce frailty inequalities should focus on the socioeconomic environment across the life course, with particular attention paid to those with consistently low SEP and downward mobility.

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社会流动会影响中国成年人晚年的虚弱轨迹吗？一项全国性纵向研究

背景和目的：关于生命历程中社会经济地位（SEP）的流动性对晚年虚弱轨迹的影响，目前尚无明确的证据。我们旨在研究中国中老年人群中社会流动性对虚弱轨迹的纵向影响：研究设计：我们分析了 2011-2018 年中国健康与退休纵向研究中 13 239 名 45 岁及以上的参与者。根据SEP从儿童到成年的变化，建立了5种社会流动模式。在每次随访时，研究人员制定了 32 项赤字累积虚弱指数（FI）来评估虚弱轨迹。采用线性混合效应模型来研究 5 种社会流动模式与虚弱轨迹的纵向关联：结果：在随访期间，所有 5 个社会流动群体的晚年虚弱程度轨迹都有所上升。FI轨迹在稳定的高SEP和稳定的低SEP之间差异最大，在向下流动组中，FI的增长速度为0.489（95%置信区间[CI]：0.327-0.650，P = .001）；在向上流动组中，FI的增长速度为0.145（95%置信区间：0.017-0.273，P = .03）。社会流动性对虚弱轨迹的影响在中年人和女性中更为明显：这些发现强调，识别弱势人群和减少虚弱不平等的政策应关注整个生命过程中的社会经济环境，尤其要关注那些社会经济地位持续低下和向下流动的人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Innovation in Aging GERIATRICS & GERONTOLOGY-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.