Lifetime socioeconomic inequalities in physical and cognitive aging.

OBJECTIVES We examined the relationship between childhood and adult socioeconomic position (SEP) and objectively assessed, later-life functioning. METHODS We used the Medical Research Council's National Survey of Health and Development data to examine performance at 60 to 64 years (obtained in 2006-2011) for a representative UK sample. We compared 9 physical and cognitive performance measures (forced expiratory volume, forced vital capacity, handgrip strength, chair rise time, standing balance time, timed get up and go speed, verbal memory score, processing speed, and simple reaction time) over the SEP distribution. RESULTS Each performance measure was socially graded. Those at the top of the childhood SEP distribution had between 7% and 20% better performance than those at the bottom. Inequalities generally persisted after adjustment for adult SEP. When we combined the 9 performance measures, the relative difference was 66% (95% confidence interval = 53%, 78%). CONCLUSIONS Public health practice should monitor and target inequalities in functional performance, as well as risk of disease and death. Effective strategies will need to affect the social determinants of health in early life to influence inequalities into old age.