Education, material condition and physical functioning trajectories in middle-aged and older adults in Central and Eastern Europe: a cross-country comparison

Abstract

BackgroundTwo competing hypotheses, cumulative advantage/disadvantage and age-as-leveller, have been proposed to explain the contradictory findings on socioeconomic differences in health over the lifespan. To test these hypotheses, this investigation examined the influence of educational attainment and material condition on individual trajectories of physical functioning (PF) in unexplored ageing populations in Central and Eastern Europe.Methods28 783 men and women aged 45–69 years selected from populations in seven Czech towns, Krakow (Poland) and Novosibirsk (Russia). PF was measured by the Physical Functioning Subscale (PF-10) of the Short-Form-36 questionnaire (SF-36) at baseline and three subsequent occasions. The highest educational attainment was self-reported at baseline, and material condition was captured by the sum score of 12 household amenities and assets.ResultsIn all cohorts, participants with a university degree had the highest PF-10 score at baseline and slowest rate of decline in the score during follow-up, while the lowest baseline scores and fastest decline rate were found in participants with less than secondary education in all cohorts and in Russians with secondary education. Similar disparities in the baseline PF-10 score and decline rate were observed across tertiles of material condition, but differences in decline rates across the three tertiles among Czechs or between the lower two tertiles among Russians were not statistically significant.ConclusionsDisparities in PF by educational attainment and material condition among middle-aged and older adults in Central and Eastern Europe existed at baseline and widened during ∼10 years of follow-up, supporting the cumulative advantage/disadvantage hypothesis.

Sex differences in associations between multimorbidity and physical function domains among community-dwelling adults in Singapore

“…Furthermore, as whole-body and muscle endurance, muscle strength and walking ability decrease with age [ 45 – 46 ], the decline of various physical functions with age in both men and women were also observed in the present study. Similar to the findings reported in an European study [ 47 ], lower education level was also associated with poorer physical function for both sexes. Furthermore, Malay males reported poorer physical function than Chinese males, which is consistent with the current ethnic differences in physical health in Singapore [ 48 ].…”

Frequency of data collection and estimation of trajectories of physical functioning and their associations with survival in older men: analyses of longitudinal data from the Manitoba Follow-Up Study

“…Declining trajectories of physical functioning were found in a variety of cohorts in older populations. A linear changing pattern was found among older adults with four waves of data collected over 8 years 7. A quadratic trajectory was revealed with four waves of annually collected data 15.…”

“…There is strong evidence that physical functioning is a marker of the current and future health, and the risk of mortality 7 8. The physical functioning declines with advancing age, particularly in very old age 9.…”

Putting cumulative (dis)advantages in context: Comparing the role of educational inequality in later-life functional health trajectories in England and Germany

“…This is mainly due to extensive data demands, in the form of large, high quality, longitudinal panel data spanning decades, but also the advanced methodological nature of the CAD debate, which often means restricting analysis to a well know example. As a high quality data infrastructure on ageing has matured, and a consensus on how to investigate CAD has emerged, exemplified by Wilson, Shuey and Elder’s three central tenets, the occurrence and strength of this process has been tested in contexts other than the US: across the whole of Europe [ 25 , 35 ], in individual European countries such as Germany [ 19 ], Sweden [ 18 ] and Switzerland [ 5 ], as well as comparing several European countries with contrasting positions in terms of their welfare systems [ 32 , 33 ]. These studies illustrate that the US context is exceptionally inductive to CAD processes, combining high initial levels of health problems, with a large educational health gap, both widening over time within cohorts, as well as widening up for younger cohorts [ 33 ].…”