Association of childhood and adulthood socioeconomic status with frailty index trajectories: Using five-wave panel data from the China Health and Retirement Longitudinal Study (CHARLS)

Abstract

Background

The relationship between childhood and adulthood socioeconomic status (SES) and long-term frailty trajectories is unclear. We aimed to assess the frailty index (FI) dynamic trajectories and examine the associations between childhood and adulthood SES and frailty trajectories.

Methods

We included 7321 participants aged 45 and older from the 2011–2020 China Health and Retirement Longitudinal Study (CHARLS). Six childhood SES factors and four adulthood SES factors were included. Group-based trajectory modelling was used to identify frailty trajectories and multinomial logistic regression was used to assess the association between SES and frailty trajectories.

Results

Three frailty trajectory groups were identified: low-increase trajectory (LT, 59.9 %), moderate-increase trajectory (MT, 31.7 %) and high-increase trajectory (HT, 8.4 %). With the LT group as reference, for childhood SES, participants with an illiterate mother (relative-risk radio [RRR]=1.67, 95 % confidence interval [CI]: 1.10–2.52), having not enough food (1.67, 1.34–2.09), with family's financial situation (2.35, 1.61–3.42) and childhood health status (2.72, 2.09–3.53) worse than others had higher odds of being in the HT group. For adulthood SES, rural residence (1.86, 1.50–2.31), with an educational level of less than middle school (2.75, 1.83–4.15), had higher odds of being in the HT group. Similar results were found for people of different ages, genders, and residences.

Conclusions

Participants with lower SES, including maternal and self- low education, childhood hunger, worse family financial and childhood health status are more likely to experience a high-increase FI trajectory, i.e. aging faster. Attention should be paid to reduce early-life social inequalities thus to promote later-time healthy aging.