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Life-course socioeconomic conditions, multimorbidity and polypharmacy in older adults: A retrospective cohort study

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  • Katharina Tabea Jungo
  • Boris Cheval
  • Stefan Sieber
  • Bernadette Wilhelmina Antonia van der Linden
  • Andreas Ihle
  • Cristian Carmeli
  • Arnaud Chiolero
  • Sven Streit
  • Stéphane Cullati

Abstract

Socioeconomic conditions across the life course may contribute to differences in multimorbidity and polypharmacy in old age. However, whether the risk of multimorbidity changes during ageing and whether life-course socioeconomic conditions are associated with polypharmacy remain unclear. We investigated whether disadvantaged childhood socioeconomic conditions (CSCs) predict increased odds of multimorbidity and polypharmacy in older adults, whether CSCs remain associated when adjusting for adulthood socioeconomic conditions (ACSs), and whether CSCs and ACSs are associated cumulatively over the life course. We used data for 31,432 participants (multimorbidity cohort, mean [SD] age 66·2[9] years), and 21,794 participants (polypharmacy cohort, mean age 69·0[8.9] years) from the Survey of Health, Ageing, and Retirement in Europe (age range 50–96 years). We used mixed-effects logistic regression to assess the associations of CSCs, ASCs, and a life-course socioeconomic conditions score (0–8; 8, most advantaged) with multimorbidity (≥2 chronic conditions) and polypharmacy (≥5 drugs taken daily). We found an association between CSCs and multimorbidity (reference: most disadvantaged; disadvantaged: odds ratio (OR) = 0·79, 95% confidence interval (CI) 0·70–0·90; middle: OR = 0·60; 95%CI 0·53–0·68; advantaged: OR = 0·52, 95%CI 0·45–0·60, most advantaged: OR = 0·40, 95%CI 0·34–0·48) but not polypharmacy. This multimorbidity association was attenuated but remained significant after adjusting for ASCs. The life-course socioeconomic conditions score was associated with multimorbidity and polypharmacy. We did not find an association between CSCs, life-course socioeconomic conditions, and change in odds of multimorbidity and polypharmacy with ageing. Exposure to disadvantaged socioeconomic conditions in childhood or over the entire life-course could predict multimorbidity in older age.

Suggested Citation

  • Katharina Tabea Jungo & Boris Cheval & Stefan Sieber & Bernadette Wilhelmina Antonia van der Linden & Andreas Ihle & Cristian Carmeli & Arnaud Chiolero & Sven Streit & Stéphane Cullati, 2022. "Life-course socioeconomic conditions, multimorbidity and polypharmacy in older adults: A retrospective cohort study," PLOS ONE, Public Library of Science, vol. 17(8), pages 1-17, August.
    • Handle: RePEc:plo:pone00:0271298
    DOI: 10.1371/journal.pone.0271298
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    References listed on IDEAS

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    1. Ye Luo & Linda J. Waite, 2005. "The Impact of Childhood and Adult SES on Physical, Mental, and Cognitive Well-Being in Later Life," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 60(2), pages 93-101.
    2. Dale Dannefer, 2003. "Cumulative Advantage/Disadvantage and the Life Course: Cross-Fertilizing Age and Social Science Theory," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 58(6), pages 327-337.
    3. Haas, Steven A. & Oi, Katsuya, 2018. "The developmental origins of health and disease in international perspective," Social Science & Medicine, Elsevier, vol. 213(C), pages 123-133.
    4. Sieber, Stefan & Orsholits, Dan & Cheval, Boris & Ihle, Andreas & Kelly-Irving, Michelle & Delpierre, Cyrille & Burton-Jeangros, Claudine & Cullati, Stéphane, 2022. "Social protection expenditure on health in later life in 20 European countries: Spending more to reduce health inequalities," Social Science & Medicine, Elsevier, vol. 292(C).
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