Growing up in poverty can leave permanent biological marks, significantly increasing the chances of frailty in old age, even decades later. New evidence from nearly 80,000 adults across 29 countries highlights the long-term health impact of early poverty.
In a recent study published in Scientific Reports, Dr. Gindo Tampubolon, a researcher at the University of Manchester, investigated whether childhood poverty makes people more prone to signs of frailty in old age. The findings reveal that childhood poverty is strongly linked to an increased likelihood of frailty in later life, with women generally being more susceptible.
Frailty is an age-related condition characterized by the decline of multiple organ systems, leading to worse clinical outcomes and higher medical costs. Previous research has shown that adults who grew up in impoverished environments tend to have poorer muscle strength, mental health, and memory as they age. This study contributes to the “long arm of childhood conditions” concept, which suggests that early adversity can have a lasting impact on an individual’s life.
Study Background
Childhood poverty is known to elevate the risk of health issues in later years, such as disability, cognitive decline, and physical frailty. Previous studies have found that adults raised in poverty in high-income countries often experience poorer physical and mental health outcomes as they age. However, the specific link between childhood poverty and frailty, a complex syndrome that involves the weakening of multiple bodily systems, had not been thoroughly explored.
Dr. Tampubolon’s study tests whether childhood poverty is a predictor of frailty in older adults, even when factors like education, marital status, and adult health are considered. The research involved data from three large aging studies, covering nearly 80,000 older individuals from the United States, the United Kingdom, and Europe, and investigated whether the material conditions of childhood poverty still influence frailty in individuals over 50 years old. It also examined the role of social health determinants across the lifespan and how these influences might vary by gender or country.
Research Methodology
The study utilized the frailty phenotype approach, developed by Fried and colleagues, which defines frailty as meeting at least three out of five indicators: exhaustion, unintentional weight loss, weakness, low energy, and slowness. To ensure consistency, this binary outcome (frail vs. non-frail) was applied across the three datasets, with slowness measured by walking speed tests in the U.S. and England, while mobility issues were self-reported in Europe.
Childhood poverty was assessed through retrospective self-reports from participants aged 50–95, with an average age of 66. To mitigate recall errors, especially in older participants, a latent class approach was used to create a more reliable measure of childhood poverty. The data collected from the British and European surveys included indicators such as the number of rooms, access to indoor plumbing, and heating. In contrast, the American survey focused on more financially oriented indicators, such as moving due to financial hardship.
A fixed effects probit model was applied to estimate the relationship between childhood poverty and frailty, adjusting for confounding factors across the lifespan, including parental occupation, childhood illness, current age, sex, education, wealth, and marital status.
Study Findings
The study analyzed data from nearly 80,000 people, including participants from the United States, England, and 27 European countries, with a focus on those who completed retrospective interviews. The sample was 57% female, with an average age of 66.3 years. Among the participants, 25.6% in Europe, 6% in the U.S., and 18.6% in England had experienced childhood poverty.
The results revealed that childhood poverty significantly increased the likelihood of frailty in old age. Women were more likely to be frail overall, while higher levels of education and wealth acted as protective factors. Additionally, childhood illnesses and having a father in a manual occupation were also associated with a higher risk of frailty.
Country-specific analysis revealed that childhood poverty consistently raised the risk of frailty between the ages of 70 and 90, with significant regional differences observed across Europe. The overall frailty prevalence was 1.7% in the U.S., 4.3% in England, and 13.4% in Europe. Sensitivity analyses, including random effects and sex-stratified models, confirmed the robustness of these findings.
Conclusions
This study provides the first comprehensive cross-national evidence from 29 high-income countries linking childhood poverty to frailty in old age. Despite differences in healthcare systems and welfare support, the association holds true across nations. The findings suggest that childhood poverty may cause long-term biological effects, possibly through epigenetic changes, which may predispose individuals to frailty. Previous U.S. research has observed accelerated epigenetic aging in those who grew up in poverty, which could be a mechanism at play.
While the study’s strengths include its broad international scope and the use of advanced methods to reduce data error, its observational nature limits causal conclusions. Additionally, survivor and selection biases remain concerns.
Future research should focus on low- and middle-income countries, where childhood poverty is more prevalent, in line with the UN Decade of Healthy Aging. Addressing childhood poverty is crucial for improving health outcomes throughout the life course.
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