Kamis , 07 Jan 2021 14:28:31
Life-course socioeconomic disadvantage and lung function: a multicohort study of 70 496 individuals


Abstract

Background Lung function is an important predictor of health and a marker of physical functioning at older ages. This study aimed to quantify the years of lung function lost according to disadvantaged socioeconomic conditions across life-course.

Methods This multicohort study used harmonised individual-level data from six European cohorts with information on life-course socioeconomic disadvantage and lung function assessed by FEV1 and FVC. 70496 participants (51% women) aged 18–93 years were included. Socioeconomic disadvantage was measured in early life (low paternal occupational position), early adulthood (low educational level), and adulthood (low occupational position). Risk factors for poor lung function (e.g., smoking, obesity, sedentary behaviour, cardiovascular and respiratory diseases) were included as potential mediators. The years of lung function lost due to socioeconomic disadvantage were computed at each life stage.

Results Socioeconomic disadvantage during life-course was associated with a lower FEV1. By age 45, individuals experiencing disadvantaged socioeconomic conditions had lost 4 to 5 years of healthy lung function versus their more advantaged counterparts (low educational level: −4.36 [95% CI −7.33; −2.37] for men and −5.14 [−10.32; −2.71] for women; low occupational position: −5.62 [−7.98; −4.90] for men and −4.32 [−13.31; −2.27] for women), after accounting for the risk factors for lung function. By ages 65 and 85, the years lung function lost due to socioeconomic disadvantage decreased by 2 to 4 years, depending on the socioeconomic indicator. Sensitivity analysis using FVC yielded similar results to those using FEV1.

Conclusion Life-course socioeconomic disadvantage is associated with lower lung function and predicts a significant number of years of lung function loss in adulthood and older ages.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Rocha reports grants from Fundação para a Ciência e Tecnologia, during the conduct of the study;.

Conflict of interest: Dr. Fraga reports grants from Fundação para a Ciência e Tecnologia, during the conduct of the study;.

Conflict of interest: Dr. Moreira has nothing to disclose.

Conflict of interest: Dr. Carmeli has nothing to disclose.

Conflict of interest: Dr. Lenoir has nothing to disclose.

Conflict of interest: Dr. Steptoe has nothing to disclose.

Conflict of interest: Dr. Giles has nothing to disclose.

Conflict of interest: Dr. Goldberg has nothing to disclose.

Conflict of interest: Dr. Zins has nothing to disclose.

Conflict of interest: Dr. Kivimaki reports grants from Medical Research Council , grants from US National Institute on Aging, grants from NordForsk, the Academy of Finland , grants from Helsinki Institute of Life Science, during the conduct of the study;.

Conflict of interest: Dr. Vineis has nothing to disclose.

Conflict of interest: Dr. Vollenweider has nothing to disclose.

Conflict of interest: Dr. Barros has nothing to disclose.

Conflict of interest: Dr. Stringhini reports grants from University of Lausanne, during the conduct of the study;.

  • Received May 5, 2020.
  • Accepted September 10, 2020.