<p>Frailty,
generally characterized as a clinical state of increased vulnerability
resulting from age-related decline in reserve and function across multiple
physiologic systems, has been gaining attention in recent years due to its high
correlates with a number of poor health outcomes including falls,
hospitalization, and mortality. Although
policy makers, health practitioners, and researchers have acknowledged that
frailty is a major public health issue, few have investigated the life course
predictors of this devastating and costly syndrome. The purpose of this dissertation is (1) to
identify the early and later-life predictors of initial frailty and frailty
growth over time among older US adults, (2) to examine if childhood exposures
influence frailty directly and/or indirectly through adult risks and resources,
and (3) to examine the role that social relationships play in frailty
trajectories among older adults. Drawing
from cumulative inequality theory, this dissertation uses longitudinal data
from the Health and Retirement Study (HRS) to examine the effects of childhood
exposures, adult risks/resources, and social relationships on frailty
trajectories among adults 65 and older. The empirical investigation is
presented in two main chapters.</p>
<p>The
first study investigates the life course predictors of frailty prevalence and
further examines how childhood exposures may be directly and indirectly
associated with frailty through adult risks and resources. The second study
builds on the findings of the first by examining the predictors of frailty
growth over time and investigating how social relationships in later life may
shape that growth. Findings reveal each
childhood exposure domain influences frailty either directly or indirectly
through adult factors and experiences.
Specifically, analyses reveal that childhood chronic disease,
impairments, and risky adolescent behaviors directly influence frailty in later
life. Additionally, results reveal that poor
childhood SES was one of the most consistent predictors of adult frailty—but
much of the effect was due to its influence on adult risks and resources. Few adult risk factors influence frailty
trajectories over time. Among adult
resources, socioeconomic status (particularly education) slows frailty growth
over time. Finally, findings reveal that both social support and more social
roles mediate the relationship between childhood exposures and frailty, and
that the effect of more social roles continues over time. </p>
<p>This
dissertation highlights a number of life course predictors of frailty and identifies
areas for potential interventions—particularly those aimed at providing equal
access to higher education and quality social relationships over the life
course. Most importantly, this dissertation
demonstrates that frailty prevention should not be a task delegated exclusively
to older adults. Effective prevention of
this often devastating and costly syndrome should begin early in life.</p>
| Identifer | oai:union.ndltd.org:purdue.edu/oai:figshare.com:article/12730973 |
| Date | 29 July 2020 |
| Creators | Monica M Farrelly (9179777) |
| Source Sets | Purdue University |
| Detected Language | English |
| Type | Text, Thesis |
| Rights | CC BY 4.0 |
| Relation | https://figshare.com/articles/thesis/Life_Course_Origins_of_Frailty_in_Later_Life/12730973 |
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