Lifelong Disadvantage and Late Adulthood Frailty
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data
2.2. Measures
2.3. Analysis
3. Results
3.1. Descriptive Results
3.2. Lifelong Disadvantage: Persistence
3.3. Lifelong Disadvantage: Coexistence
3.4. A Breakdown by Welfare Regime
- Bismarckian Europe (Austria, Germany, Netherlands, France, Switzerland, Belgium, and Luxembourg),
- Scandinavian countries (Sweden and Denmark),
- Southern Europe (Spain, Italy, Greece, and Portugal), and
- Eastern Europe (Czech Republic, Poland, Hungary, Slovenia, Estonia, and Croatia).
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Coef. | SE | Coef. | SE | Coef. | SE | Coef. | SE | Coef. | SE | ||||||
Age: 60−64 | |||||||||||||||
65−69 | 1.15 | *** | 0.07 | 1.19 | *** | 0.08 | 1.22 | *** | 0.07 | 1.21 | *** | 0.07 | 1.22 | *** | 0.07 |
70−74 | 3.00 | *** | 0.09 | 3.06 | *** | 0.10 | 3.06 | *** | 0.09 | 3.04 | *** | 0.09 | 3.06 | *** | 0.09 |
75−79 | 5.33 | *** | 0.12 | 5.41 | *** | 0.13 | 5.42 | *** | 0.12 | 5.35 | *** | 0.12 | 5.47 | *** | 0.12 |
Unemployment (U) | 0.01 | 0.01 | 0.01 | * | 0.00 | 0.01 | * | 0.00 | 0.01 | * | 0.00 | 0.01 | * | 0.00 | |
Stress (S) | 0.02 | *** | 0.00 | 0.02 | *** | 0.00 | 0.02 | *** | 0.00 | 0.02 | *** | 0.00 | 0.02 | *** | 0.00 |
Illness (I) | 0.09 | *** | 0.00 | 0.09 | *** | 0.00 | 0.09 | *** | 0.00 | 0.09 | *** | 0.00 | 0.09 | *** | 0.00 |
Financial Hardship (FH) | 0.03 | *** | 0.00 | 0.03 | *** | 0.00 | 0.03 | *** | 0.00 | 0.03 | *** | 0.00 | 0.03 | *** | 0.00 |
Coexisting Disadvantages (CD) = Yes | 1.13 | *** | 0.15 | 1.12 | *** | 0.15 | 1.12 | *** | 0.15 | 1.13 | *** | 0.15 | 1.37 | *** | 0.17 |
65−69 # U | 0.00 | 0.01 | |||||||||||||
70−74 # U | 0.01 | 0.01 | |||||||||||||
75−79 # U | 0.01 | 0.01 | |||||||||||||
60−64 # S | |||||||||||||||
65−69 # S | 0.00 | 0.00 | |||||||||||||
70−74 # S | 0.00 | 0.00 | |||||||||||||
75−79 # S | −0.01 | 0.01 | |||||||||||||
65−69 # I | −0.01 | * | 0.00 | ||||||||||||
70−74 # I | −0.01 | 0.01 | |||||||||||||
75−79 # I | −0.01 | 0.01 | |||||||||||||
65−69 # FH | −0.01 | 0.00 | |||||||||||||
70−74 # FH | 0.00 | 0.01 | |||||||||||||
75−79 # FH | 0.00 | 0.01 | |||||||||||||
65−69 # CD = 1 | −0.32 | 0.19 | |||||||||||||
70−74 # CD = 1 | −0.24 | 0.27 | |||||||||||||
75−79 # CD = 1 | −0.80 | * | 0.36 | ||||||||||||
Childhood health (fair, poor, varied) | 2.47 | *** | 0.16 | 2.48 | *** | 0.16 | 2.47 | *** | 0.16 | 2.48 | *** | 0.16 | 2.48 | *** | 0.16 |
Childhood stressful events | 0.73 | *** | 0.10 | 0.73 | *** | 0.10 | 0.73 | *** | 0.10 | 0.73 | *** | 0.10 | 0.73 | *** | 0.10 |
Female | 2.05 | *** | 0.08 | 2.04 | *** | 0.08 | 2.05 | *** | 0.08 | 2.05 | *** | 0.08 | 2.05 | *** | 0.08 |
Educational level: Low | |||||||||||||||
Mid Education | −2.45 | *** | 0.12 | −2.45 | *** | 0.12 | −2.45 | *** | 0.12 | −2.45 | *** | 0.12 | −2.45 | *** | 0.12 |
High Education | −4.14 | *** | 0.13 | −4.14 | *** | 0.13 | −4.14 | *** | 0.13 | −4.14 | *** | 0.13 | −4.14 | *** | 0.13 |
Wave: 1 (2004–2005) | |||||||||||||||
2 (2006–2007) | −0.05 | 0.09 | −0.05 | 0.09 | −0.05 | 0.09 | −0.05 | 0.09 | −0.05 | 0.09 | |||||
4 (2011–2012) | 0.33 | ** | 0.10 | 0.33 | ** | 0.10 | 0.32 | ** | 0.10 | 0.33 | ** | 0.10 | 0.33 | ** | 0.10 |
5 (2013) | 0.40 | *** | 0.11 | 0.40 | *** | 0.11 | 0.40 | *** | 0.11 | 0.40 | *** | 0.11 | 0.40 | *** | 0.11 |
6 (2015) | 0.37 | *** | 0.11 | 0.37 | *** | 0.11 | 0.37 | *** | 0.11 | 0.37 | *** | 0.11 | 0.37 | *** | 0.11 |
7 (2017) | 0.19 | 0.13 | 0.19 | 0.13 | 0.19 | 0.13 | 0.19 | 0.13 | 0.19 | 0.13 | |||||
Country: Austria | |||||||||||||||
Germany | 1.61 | *** | 0.23 | 1.61 | *** | 0.23 | 1.61 | *** | 0.23 | 1.61 | *** | 0.23 | 1.61 | *** | 0.23 |
Sweden | −1.30 | *** | 0.22 | −1.30 | *** | 0.22 | −1.30 | *** | 0.22 | −1.30 | *** | 0.22 | −1.30 | *** | 0.22 |
Netherlands | −1.14 | *** | 0.25 | −1.14 | *** | 0.25 | −1.14 | *** | 0.25 | −1.14 | *** | 0.25 | −1.14 | *** | 0.25 |
Spain | 2.13 | *** | 0.25 | 2.12 | *** | 0.25 | 2.13 | *** | 0.25 | 2.13 | *** | 0.25 | 2.13 | *** | 0.25 |
Italy | 1.33 | *** | 0.24 | 1.32 | *** | 0.24 | 1.33 | *** | 0.24 | 1.33 | *** | 0.24 | 1.32 | *** | 0.24 |
France | 0.79 | *** | 0.23 | 0.78 | *** | 0.23 | 0.79 | *** | 0.23 | 0.79 | *** | 0.23 | 0.79 | *** | 0.23 |
Denmark | −0.51 | * | 0.24 | −0.51 | * | 0.24 | −0.51 | * | 0.24 | −0.51 | * | 0.24 | −0.51 | * | 0.24 |
Greece | −0.28 | 0.23 | −0.28 | 0.23 | −0.28 | 0.23 | −0.28 | 0.23 | −0.28 | 0.23 | |||||
Switzerland | −2.37 | *** | 0.22 | −2.37 | *** | 0.22 | −2.36 | *** | 0.22 | −2.36 | *** | 0.22 | −2.37 | *** | 0.22 |
Belgium | 1.21 | *** | 0.23 | 1.21 | *** | 0.23 | 1.21 | *** | 0.23 | 1.21 | *** | 0.23 | 1.21 | *** | 0.23 |
Czech Republic | 2.14 | *** | 0.23 | 2.14 | *** | 0.23 | 2.14 | *** | 0.23 | 2.14 | *** | 0.23 | 2.14 | *** | 0.23 |
Poland | 6.48 | *** | 0.33 | 6.47 | *** | 0.33 | 6.47 | *** | 0.33 | 6.47 | *** | 0.33 | 6.46 | *** | 0.33 |
Luxembourg | 1.76 | *** | 0.41 | 1.76 | *** | 0.40 | 1.76 | *** | 0.41 | 1.76 | *** | 0.41 | 1.76 | *** | 0.41 |
Hungary | 7.55 | *** | 0.43 | 7.56 | *** | 0.43 | 7.56 | *** | 0.43 | 7.55 | *** | 0.43 | 7.56 | *** | 0.43 |
Portugal | 4.85 | *** | 0.44 | 4.85 | *** | 0.44 | 4.85 | *** | 0.44 | 4.85 | *** | 0.44 | 4.85 | *** | 0.44 |
Slovenia | 2.10 | *** | 0.26 | 2.10 | *** | 0.26 | 2.11 | *** | 0.26 | 2.11 | *** | 0.26 | 2.10 | *** | 0.26 |
Estonia | 5.08 | *** | 0.24 | 5.08 | *** | 0.24 | 5.08 | *** | 0.24 | 5.08 | *** | 0.24 | 5.08 | *** | 0.24 |
Croatia | 3.11 | *** | 0.35 | 3.11 | *** | 0.35 | 3.11 | *** | 0.35 | 3.12 | *** | 0.35 | 3.12 | *** | 0.35 |
Constant | 8.97 | *** | 0.23 | 8.93 | *** | 0.23 | 8.93 | *** | 0.23 | 8.95 | *** | 0.23 | 8.91 | *** | 0.23 |
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Variables | Categories | Age Groups | ||||
---|---|---|---|---|---|---|
60–64 | 65–69 | 70–74 | 75–79 | |||
Frailty Index | Mean | 10.70 | 11.88 | 13.89 | 16.41 | |
Life course disadvantages | ||||||
Unemployment | Never | % | 85.88 | 89.07 | 91.76 | 93.81 |
Occasionally | % | 10.40 | 8.31 | 6.32 | 4.62 | |
Frequently | % | 3.72 | 2.63 | 1.92 | 1.57 | |
Severe stress | Never | % | 53.57 | 57.48 | 62.88 | 68.57 |
Occasionally | % | 29.64 | 26.66 | 22.44 | 18.48 | |
Frequently | % | 16.79 | 15.85 | 14.68 | 12.95 | |
Illness | Never | % | 85.22 | 86.04 | 87.00 | 88.37 |
Occasionally | % | 7.02 | 6.50 | 6.10 | 5.14 | |
Frequently | % | 7.76 | 7.46 | 6.90 | 6.49 | |
Financial hardship | Never | % | 72.32 | 75.21 | 77.15 | 77.91 |
Occasionally | % | 17.42 | 15.72 | 14.14 | 12.87 | |
Frequently | % | 10.25 | 9.07 | 8.70 | 9.22 | |
Coexisting disadvantages | Never | % | 79.36 | 82.21 | 85.30 | 87.96 |
At least 1% | % | 20.64 | 17.79 | 14.70 | 12.04 | |
Additional covariates | ||||||
Childhood health | Fair, poor, varied | % | 9.83 | 10.72 | 11.65 | 12.01 |
Childhood stressful events | Mean | 0.23 | 0.23 | 0.24 | 0.23 | |
SD | 0.47 | 0.48 | 0.49 | 0.48 | ||
Gender | Female | % | 55.41 | 54.46 | 54.29 | 54.82 |
Educational level | Low Education | % | 17.50 | 23.16 | 29.73 | 37.23 |
Mid Education | % | 54.27 | 50.20 | 46.35 | 41.70 | |
High Education | % | 28.23 | 26.64 | 23.93 | 21.07 | |
Wave | 1 (2004–2005) | % | 8.78 | 7.77 | 7.58 | 6.89 |
2 (2006–2007) | % | 13.01 | 11.42 | 11.21 | 11.00 | |
4 (2011–2012) | % | 21.34 | 19.26 | 19.67 | 18.54 | |
5 (2013) | % | 22.97 | 23.38 | 23.19 | 22.56 | |
6 (2015) | % | 27.06 | 28.76 | 28.14 | 29.98 | |
7 (2017) | % | 6.85 | 9.42 | 10.20 | 11.04 | |
Country | Austria | % | 5.69 | 5.76 | 6.99 | 5.63 |
Belgium | % | 9.79 | 9.59 | 9.11 | 10.08 | |
Croatia | % | 1.08 | 1.04 | 0.91 | 0.94 | |
Czech Republic | % | 7.84 | 8.79 | 7.83 | 6.96 | |
Denmark | % | 7.02 | 6.80 | 6.09 | 5.78 | |
Estonia | % | 6.00 | 6.07 | 7.25 | 7.84 | |
France | % | 7.91 | 7.09 | 6.83 | 7.88 | |
Germany | % | 7.25 | 6.91 | 7.03 | 6.78 | |
Greece | % | 5.07 | 5.07 | 5.18 | 4.89 | |
Hungary | % | 0.99 | 0.75 | 0.65 | 0.45 | |
Italy | % | 8.16 | 8.79 | 8.99 | 8.78 | |
Luxembourg | % | 1.07 | 1.04 | 0.79 | 0.53 | |
Netherlands | % | 4.12 | 3.48 | 3.20 | 2.92 | |
Poland | % | 3.55 | 3.17 | 2.76 | 2.79 | |
Portugal | % | 1.19 | 1.30 | 1.00 | 0.82 | |
Slovenia | % | 4.04 | 3.42 | 3.64 | 3.44 | |
Spain | % | 7.15 | 7.33 | 8.30 | 9.68 | |
Sweden | % | 6.84 | 8.21 | 8.27 | 8.17 | |
Switzerland | % | 5.23 | 5.41 | 5.17 | 5.64 | |
N | 32,809 | 30,960 | 25,044 | 18,180 |
Additional Disadvantage, 50% of Adult Life | |||||||||
---|---|---|---|---|---|---|---|---|---|
Only One | Not coexisting | Coexisting | |||||||
Disadvantage | Unempl. | Stress | Illness | Fin. Hard. | Unempl. | Stress | Illness | Fin. Hard. | |
Unemployment (50%) | |||||||||
60–64 | 10.1 | 11.2 | 14.5 | 11.5 | 12.6 | 15.9 | 12.9 | ||
0.29 | 0.26 | 0.29 | 0.29 | 0.27 | 0.29 | 0.28 | |||
65–69 | 11.4 | 12.4 | 15.8 | 12.7 | 13.5 | 16.8 | 13.8 | ||
0.35 | 0.27 | 0.29 | 0.29 | 0.29 | 0.30 | 0.29 | |||
70–74 | 13.5 | 14.3 | 17.6 | 14.6 | 15.4 | 18.7 | 15.7 | ||
0.46 | 0.27 | 0.29 | 0.29 | 0.33 | 0.35 | 0.34 | |||
75–79 | 15.8 | 16.7 | 20.0 | 17.0 | 17.2 | 20.6 | 17.6 | ||
0.65 | 0.28 | 0.30 | 0.30 | 0.40 | 0.41 | 0.40 | |||
Stress (50%) | |||||||||
60–64 | 10.8 | 15.0 | 12.0 | 16.4 | 13.4 | ||||
0.14 | 0.19 | 0.18 | 0.20 | 0.18 | |||||
65–69 | 11.9 | 16.2 | 13.2 | 17.3 | 14.3 | ||||
0.15 | 0.20 | 0.19 | 0.22 | 0.20 | |||||
70–74 | 13.7 | 18.1 | 15.1 | 19.2 | 16.2 | ||||
0.18 | 0.20 | 0.19 | 0.27 | 0.25 | |||||
75–79 | 16.0 | 20.5 | 17.5 | 21.1 | 18.0 | ||||
0.24 | 0.21 | 0.20 | 0.34 | 0.32 | |||||
Illness (50%) | |||||||||
60–64 | 14.4 | 15.4 | 16.7 | ||||||
0.21 | 0.22 | 0.21 | |||||||
65–69 | 15.1 | 16.6 | 17.6 | ||||||
0.21 | 0.22 | 0.23 | |||||||
70–74 | 17.0 | 18.4 | 19.5 | ||||||
0.26 | 0.23 | 0.27 | |||||||
75–79 | 19.2 | 20.8 | 21.4 | ||||||
0.30 | 0.24 | 0.34 | |||||||
Financial Hardship (50%) | |||||||||
60–64 | 11.2 | ||||||||
0.20 | |||||||||
65–69 | 12.0 | ||||||||
0.21 | |||||||||
70–74 | 14.0 | ||||||||
0.23 | |||||||||
75–79 | 16.5 | ||||||||
0.31 |
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Zanasi, F.; De Santis, G.; Pirani, E. Lifelong Disadvantage and Late Adulthood Frailty. J. Ageing Longev. 2022, 2, 12-25. https://doi.org/10.3390/jal2010002
Zanasi F, De Santis G, Pirani E. Lifelong Disadvantage and Late Adulthood Frailty. Journal of Ageing and Longevity. 2022; 2(1):12-25. https://doi.org/10.3390/jal2010002
Chicago/Turabian StyleZanasi, Francesca, Gustavo De Santis, and Elena Pirani. 2022. "Lifelong Disadvantage and Late Adulthood Frailty" Journal of Ageing and Longevity 2, no. 1: 12-25. https://doi.org/10.3390/jal2010002
APA StyleZanasi, F., De Santis, G., & Pirani, E. (2022). Lifelong Disadvantage and Late Adulthood Frailty. Journal of Ageing and Longevity, 2(1), 12-25. https://doi.org/10.3390/jal2010002