Early-life effects on socio-economic performance and mortality in later life: A full life-course approach using contemporary and historical sources

This chapter describes the theoretical and mechanistic basis, and public health implications, of the Developmental Origins of Health and Disease (DOHaD) paradigm, which has emerged from overwhelming epidemiological, clinical, and experimental evidence demonstrating the importance of early life development in influencing an individual’s susceptibility to later life disease risk. DOHaD is underpinned by the evolutionarily conserved processes of developmental plasticity. These enable phenotypic adjustment to match the environment and are effected, in part, by epigenetic mechanisms that modulate patterns of gene expression. This chapter uses obesity and its co-morbidities to illustrate how a life course approach can provide an effective strategy for reducing disease risk and have major policy implications. It focuses on early life as a critical intervention point, and recognizes the importance of taking into consideration the full range of influencial biological, behavioural, and contextual factors that operate across the life course.

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Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia

BMC Urology ◽

10.1186/s12894-021-00816-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saira Khan ◽

K. Y. Wolin ◽

R. Pakpahan ◽

R. L. Grubb ◽

G. A. Colditz ◽

...

Keyword(s):

Body Size ◽

Benign Prostatic Hyperplasia ◽

Life Course ◽

Early Life ◽

Prostate Volume ◽

Late Life ◽

Later Life ◽

Normal Weight ◽

Prostatic Hyperplasia ◽

The Life Course

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.

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A Life Course Approach to Inequality: Examining Racial/Ethnic Differences in the Relationship between Early Life Socioeconomic Conditions and Health in Later Life Among Men

Ethnicity & Disease ◽

10.18865/ed.25.3.313 ◽

2015 ◽

Vol 25 (3) ◽

pp. 313 ◽

Cited By ~ 5

Author(s):

Taylor W. Hargrove, MA ◽

Tyson H. Brown, PhD

Keyword(s):

Life Course ◽

Mexican American ◽

White Men ◽

Later Life ◽

Adult Health ◽

Socioeconomic Conditions ◽

Growth Curve Models ◽

Life Course Approach ◽

Race Ethnicity ◽

Racial Ethnic

Objective: Previous research has documented a relationship between childhood socioeconomic conditions and adult health, but less is known about racial/ethnic differences in this relationship, particularly among men. This study utilizes a life course approach to investigate racial/ethnic differences in the relationships among early and later life socioeconomic circumstances and health in adulthood among men.Design: Panel data from the Health and Retirement Study and growth curve models are used to examine group differences in the relationships among childhood and adult socioeconomic factors and age-trajectories of self-rated health among White, Black and Mexican American men aged 51-77 years (N=4147).Results: Multiple measures of childhood socioeconomic status (SES) predict health in adulthood for White men, while significantly fewer measures of childhood SES predict health for Black and Mexican American men. Moreover, the health consequences of childhood SES diminish with age for Black and Mexican American men. The childhood SES-adult health relationship is largely explained by measures of adult SES for White men.Conclusion: The life course pathways linking childhood SES and adult health differ by race/ethnicity among men. Similar to arguments that the universality of the adult SES-health relationship should not be assumed, results from our study suggest that scholars should not assume that the significance and nature of the association between childhood SES and health in adulthood is similar across race/ethnicity among men. Ethn Dis.2015;25(3):313-320.

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Early-life circumstances and the risk of function-limiting long-term conditions in later life

Longitudinal and Life Course Studies ◽

10.1332/175795919x15762565000695 ◽

2020 ◽

Vol 11 (2) ◽

pp. 157-180

Author(s):

Matthew H. Iveson ◽

Chris Dibben ◽

Ian J. Deary

Keyword(s):

Life Course ◽

Cognitive Ability ◽

Early Life ◽

Economic Status ◽

Functional Limitation ◽

Later Life ◽

Socio Economic Status ◽

Childhood Cognitive Ability ◽

The Life Course

Older adults are particularly prone to function-limiting health issues that adversely affect their well-being. Previous work has identified factors from across the life course –childhood socio-economic status, childhood cognitive ability and education – that predict later-life functional outcomes. However, the independence of these contributions is unclear as later-in-the-life-course predictors are themselves affected by earlier ones. The present study capitalised on the recent linkage of the Scottish Mental Survey 1947 with the Scottish Longitudinal Study, using path analyses to examine the direct and indirect associations between life-course predictors and the risk of functional limitation at ages 55 (N = 2,374), 65 (N = 1,971) and 75 (N = 1,534). The odds of reporting a function-limiting long-term condition increased across later life. At age 55, reporting a functional limitation was significantly less likely in those with higher childhood socio-economic status, higher childhood cognitive ability and higher educational attainment; these associations were only partly mediated by other predictors. At age 65, adult socio-economic status emerged as a mediator of several associations, although direct associations with childhood socio-economic status and childhood cognitive ability were still observed. At age 75, only childhood socio-economic status and adult socio-economic status directly predicted the risk of a functional limitation, particularly those associated with disease or illness. A consistent pattern and direction of associations was observed with self-rated health more generally. These results demonstrate that early-life and adult circumstances are associated with functional limitations later in life, but that these associations are partly a product of complex mediation between life-course factors.

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A life course approach for understanding later life sustainability

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0014 ◽

2017 ◽

pp. 103-110

Author(s):

Holly Syddall ◽

Avan Aihie Sayer

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Life Course ◽

Grip Strength ◽

Optimal Strategies ◽

Later Life ◽

Present Evidence ◽

Considerable Evidence ◽

Life Course Approach ◽

The Life Course

This chapter describes a life course approach for understanding later life sustainability, focusing on grip strength as a marker of physical sustainability, and explaining how a life course approach recognizes that muscle strength in later life reflects not only rate of loss in later life, but also the peak attained earlier in life. We present evidence that risk factors operating throughout the life course have an impact on physical sustainability in later life with particular consideration of the effects of body size, socioeconomic position, physical activity, diet, and smoking. We have shown that low birth weight is associated with weaker grip strength across the life course and that there is considerable evidence for developmental influences on ageing skeletal muscle. Finally, a life course approach suggests opportunities for early intervention to promote later life physical sustainability; but optimal strategies and timings for intervention are yet to be identified.

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Life course approach to understanding inequalities in health in later life

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0010 ◽

2017 ◽

pp. 69-76 ◽

Cited By ~ 1

Author(s):

Ruth Bell ◽

Michael Marmot

Keyword(s):

Life Course ◽

Social Functioning ◽

Later Life ◽

Older Age ◽

Cognitive Changes ◽

Healthy Life ◽

Inequalities In Health ◽

Biological Ageing ◽

Life Course Approach ◽

The Life Course

A long and healthy life is universally valued. The starkest inequalities in later life are how many years of life remain at an older age such as 65 years, and how many years of life that remain free from disabilities that impede physical, cognitive, and social functioning to the extent that they limit the sense of valuing one’s life. In this chapter we apply the frame of social determinants of health, using the life course approach to understand inequalities in health in later life. Healthy ageing is patterned by degrees of social advantage. Biological ageing, as revealed by physical and cognitive changes, is slower in people in better socioeconomic circumstances. These inequalities in health in later life need to be understood in terms of current social, economic, environmental conditions of living, as well as previous experiences and living conditions across the life course that affect the biological processes of ageing.

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What role for the ‘long arm of childhood’ in social gradients in health? An international comparison of high-income contexts

Longitudinal and Life Course Studies ◽

10.1332/175795920x16025975665508 ◽

2020 ◽

Author(s):

Steven A. Haas ◽

Zhangjun Zhou ◽

Katsuya Oi

Keyword(s):

Life Course ◽

Early Life ◽

Economic Status ◽

Functional Limitation ◽

Later Life ◽

High Income ◽

Childhood Health ◽

Relative Contribution ◽

Early Life Factors

Social gradients in health have been a focus of research for decades. Two important lines of social gradient research have examined (1) international variation in their magnitude and (2) their life course / developmental antecedents. The present study brings these two strands together to explore the developmental origins of educational gradients in health. We leverage data spanning 14 high-income contexts from the Health and Retirement Study and its sisters in Europe. We find that early-life health and socio-economic status consistently attenuate educational gradients in multimorbidity and functional limitation. However, the relative contribution of early-life factors to gradients varies substantially across contexts. The results suggest that research on social gradients, and population health broadly, would benefit from the unique insights available from a conceptual and empirical approach that integrates comparative and life course perspectives. Key messages <ul><li>The magnitude of educational gradients in later life health depend, in part, on childhood health and socioeconomic circumstances.</li> <li>The role of early life factors in educational gradients in health varies substantially across high income contexts.</li></ul>

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Early-life circumstances and their effect over the life course

10.31235/osf.io/b4hmv ◽

2019 ◽

Author(s):

Florencia Torche

Keyword(s):

Life Course ◽

Early Life ◽

Developmental Stages ◽

Well Being ◽

Critical Periods ◽

Special Issue ◽

Life Course Approach ◽

Life Circumstances ◽

The Life Course ◽

Research And Policy

The idea that early-life circumstances shape people’s health, development, and well-being over the life course has gained renewed centrality in the last two decades. This renewed interest has been informed by new approaches that emphasize sensitive and critical periods during the first years of life, offer an understanding of human development as a hierarchical and cross-fertilizing process, suggest plausible mechanisms for the persistent effect of early exposures, and explore heterogeneity in effects based on environmental and biological factors. The articles included in this special issue of Population Research and Policy Review advance the field of early-life circumstances in several important dimensions. They examine the determinants and effects of noxious exposures at different developmental stages—ranging from the prenatal period to adolescence—in a variety of national settings. They offer an understanding of early-life circumstances that moves from discrete outcomes to a dynamic life-course approach, and consider diverse sources of heterogeneity in the effects of early exposures.

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