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Socioeconomic inequalities in resilience and vulnerability among older adults: a population-based birth cohort analysis

Published online by Cambridge University Press:  08 November 2017

T. D. Cosco Open the ORCID record for T. D. Cosco [Opens in a new window] ,
R. Cooper ,
D. Kuh  and
M. Stafford
T. D. Cosco*
Affiliation:
MRC Unit for Lifelong Health and Ageing at UCL, London, UK Oxford Institute of Population Ageing, University of Oxford, Oxford, UK
R. Cooper
Affiliation:
MRC Unit for Lifelong Health and Ageing at UCL, London, UK
D. Kuh
Affiliation:
MRC Unit for Lifelong Health and Ageing at UCL, London, UK
M. Stafford
Affiliation:
MRC Unit for Lifelong Health and Ageing at UCL, London, UK
*
Correspondence should be addressed to: Theodore D. Cosco, MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London WC1B 5JU, UK. Phone: +44 (0) 20 7670 5700. Email: t.cosco@ucl.ac.uk.
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Abstract

Background:

Aging is associated with declines in physical capability; however, some individuals demonstrate high well-being despite this decline, i.e. they are “resilient.” We examined socioeconomic position (SEP) and resilience and the influence of potentially modifiable behavioral resources, i.e. social support and leisure time physical activity (LTPA), on these relationships.

Methods:

Data came from the Medical Research Council National Survey of Health and Development, a nationally-representative birth cohort study. Resilience–vulnerability at age 60–64 years (n = 1,756) was operationalized as the difference between observed and expected levels of well-being, captured by the Warwick–Edinburgh Mental Well-being Scale (WEMWBS), given the level of performance-based physical capability. SEP was assessed by father's and own social class, parental education, and intergenerational social mobility. PA and structural/functional social support were reported at ages 53 years and 60–64 years. Path analysis was used to examine mediation of SEP and resilience–vulnerability through LTPA and social support.

Results:

Participants in the highest social class had scores on the resilience to vulnerability continuum that were an average of 2.3 units (β = 0.46, 95% CI 0.17, 0.75) higher than those in the lowest social class. Greater LTPA (β = 0.58, 95% CI 0.31, 0.85) and social support (β = 3.27, 95% CI 2.90, 3.63) were associated with greater resilience; LTPA partly mediated participant social class and resilience (23.4% of variance).

Conclusions:

Adult socioeconomic advantage was associated with greater resilience. Initiatives to increase LTPA may contribute to reducing socioeconomic inequalities in this form of resilience in later life.

Keywords

resiliencesocial supportphysical activitysocioeconomic position
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 5: Issue Theme: Brain Imaging , May 2018 , pp. 695 - 703
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Albrecht, G. L. and Devlieger, P. J. (1999). The disability paradox: high quality of life against all odds. Social Science & Medicine, 48, 977–988.Google Scholar
Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health Promotion International, 11, 11–18.CrossRefGoogle Scholar
Cohen, S., Mermelstein, R., Kamarck, T. and Hoberman, H. M. (1985). Measuring the functional components of social support. In Sarason, I. G. and Sarason, B. R. (eds.), Social Support: Theory, Research and Applications (pp. 73–94). Dordrecht: Springer Netherlands.Google Scholar
Cooper, R. et al. (2014b). Physical capability and subsequent positive mental well-being in older people: findings from five HALCyon cohorts. Age (Dordr), 36, 445–456.Google Scholar
Cooper, R., Hardy, R., Sayer, A. A. and Kuh, D. (2014a). A life course approach to physical capability. In Kuh, D., Cooper, R., Hardy, R., Richards, M. and Ben-Shlomo, Y. (eds.), A Life Course Approach to Healthy Ageing (pp. 16–31). Oxford, UK: Oxford University Press.Google Scholar
Cooper, R., Mishra, G. D. and Kuh, D. (2011). Physical activity across adulthood and physical performance in midlife: findings from a British birth cohort. American Journal of Preventive Medicine, 41, 376–384.CrossRefGoogle ScholarPubMed
Cooper, R., Strand, B. H., Hardy, R., Patel, K. V. and Kuh, D. (2014c). Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study. BMJ, 348, g2219.Google Scholar
Elhakeem, A., Cooper, R., Bann, D. and Hardy, R. (2015). Childhood socioeconomic position and adult leisure-time physical activity: a systematic review. International Journal of Behavioral Nutrition and Physical Activity, 12, 92–119.Google Scholar
Golden, J. et al. (2009). Loneliness, social support networks, mood and well-being in community-dwelling elderly. International Journal of Geriatric Psychiatry, 24, 694–700.CrossRefGoogle Scholar
Golubic, R. et al. (2014). Levels of physical activity among a nationally representative sample of people in early old age: results of objective and self-reported assessments. International Journal of Behavioral Nutrition and Physicalctivity Act, 11, 58.CrossRefGoogle ScholarPubMed
Guralnik, J. M., Butterworth, S., Wadsworth, M. E. and Kuh, D. (2006). Childhood socioeconomic status predicts physical functioning a half century later. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 61, 694–701.CrossRefGoogle ScholarPubMed
Hu, L. T. and Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.CrossRefGoogle Scholar
Kim, J. E. and Nesselroade, J. R. (2003). Relationships among social support, self-concept, and well-being of older adults: a study of process using dynamic factor models. International Journal of Behavioral Development, 27, 49–65.CrossRefGoogle Scholar
Kuh, D. et al. (2006). Developmental origins of midlife grip strength: findings from a birth cohort study. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 61, 702–706.Google Scholar
Kuh, D. et al. (2011). Cohort profile: updating the cohort profile for the MRC National Survey of Health and Development: a new clinic-based data collection for ageing research. International Journal of Epidemiology, 40, e1–e9.Google Scholar
Kuh, D., Bassey, E. J., Butterworth, S., Hardy, R. and Wadsworth, M. E. (2005). Grip strength, postural control, and functional leg power in a representative cohort of British men and women: associations with physical activity, health status, and socioeconomic conditions. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 60, 224–231.CrossRefGoogle Scholar
Lyons, D. M., Parker, K. J., Katz, M. and Schatzberg, A. F. (2009). Developmental cascades linking stress inoculation, arousal regulation, and resilience. Frontiers in Behavioral Neuroscience, 3, 6.Google Scholar
Manton, K. G., Corder, L. and Stallard, E. (1997). Chronic disability trends in elderly United States populations: 1982–1994. Proceedings of the National Academy of Sciences of the United States of America, 94, 2593–2598.Google Scholar
Marmot, M. (2005). Social determinants of health inequalities. Lancet, 365, 1099–1104.Google Scholar
Masten, A. S. (2001). Ordinary magic: resilience processes in development. American Psychologist, 56, 227–238.Google Scholar
Miller-Lewis, L. R., Searle, A. K., Sawyer, M. G., Baghurst, P. A. and Hedley, D. (2013). Resource factors for mental health resilience in early childhood: an analysis with multiple methodologies. Child and Adolescent Psychiatry and Mental Health, 7, 6.Google Scholar
Ong, A. D., Bergeman, C. S., Bisconti, T. L. and Wallace, K. A. (2006). Psychological resilience, positive emotions, and successful adaptation to stress in later life. Journal of Personality and Social Psychology, 91, 730–749.Google Scholar
Pierce, M. B., Kuh, D. and Hardy, R. (2012). The role of BMI across the life course in the relationship between age at menarche and diabetes, in a British Birth Cohort. Diabetes Medicine, 29, 600–603.Google Scholar
Podsiadlo, D. and Richardson, S. (1991). The timed ‘Up and Go’: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39, 142–148.Google Scholar
Repetti, R. L., Taylor, S. E. and Seeman, T. E. (2002). Risky families: family social environments and the mental and physical health of offspring. Psychological Bulletin, 128, 330–366.Google Scholar
Rutter, M. (2012). Resilience as a dynamic concept. Development and Psychopathology, 24, 335–344.Google Scholar
Sacker, A. and Cable, N. (2006). Do adolescent leisure-time physical activities foster health and well-being in adulthood? Evidence from two British birth cohorts. European Journal of Public Health, 16, 331–335.Google Scholar
Stafford, M. et al. (2013). Using a birth cohort to study ageing: representativeness and response rates in the National Survey of Health and Development. European Journal of Ageing, 10, 145–157.CrossRefGoogle ScholarPubMed
Tennant, R. et al. (2007). The Warwick–Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health and Quality of Life Outcomes, 5, 63.CrossRefGoogle ScholarPubMed
Turner, R. J. and Marino, F. (1994). Social support and social structure: a descriptive epidemiology. Journal of Health and Social Behavior, 35, 193–212.Google Scholar
Wadsworth, M., Kuh, D., Richards, M. and Hardy, R. (2006). Cohort profile: the 1946 national birth cohort (MRC national survey of health and development). International Journal of Epidemiology, 35, 49–54.Google Scholar
Windle, G., Woods, R. T. and Markland, D. A. (2010). Living with Ill-Health in older age: the role of a resilient personality. Journal of Happiness Studies, 11, 763–777.CrossRefGoogle Scholar
Wister, A. V., Coatta, K. L., Schuurman, N., Lear, S. A., Rosin, M. and MacKey, D. (2016). A lifecourse model of multi-morbidity resilience: theoretical and research developments. International Journal of Aging & Human Development, 82, 290–313.CrossRefGoogle Scholar
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