Linking widowhood and later-life depressive symptoms: Do childhood socioeconomic circumstances matter?

Objectives: Widowhood and adverse childhood socioeconomic circumstances (CSC) have both been linked to increased levels of depressive symptoms in old age. Beyond their independent impact on depressive symptoms, experiencing adverse CSC may also trigger a cascade of cumulative adversity and secondary stressors across the life course that shapes how individuals weather stressful life events later on.Method: We examine whether exposure to adverse CSC moderates the relationship between later-life widowhood and depressive symptoms using data from the Survey of Health, Ageing and Retirement in Europe (2004-2017).Results: Mixed-effects models revealed that both widowhood and adverse CSC were associated with increased levels of depressive symptoms among men and women. Associations between widowhood and depressive symptoms, however, were not moderated by CSC for both genders.Conclusion: Persisting differences in the levels of mental health in response to later-life widowhood did not further widen in the presence of disparities experienced early in the life course. This may reflect the life-altering impact of this age-normative, yet stressful life event across the social strata.

Relationships between changes in self-reported physical activity, sedentary behaviour and health during the coronavirus (COVID-19) pandemic in France and Switzerland.

To assess whether changes in physical activity and sedentary behaviour during the COVID-19 lockdown are associated with changes in mental and physical health. Observational longitudinal study. Participants living in France or Switzerland responded to online questionnaires measuring physical activity, physical and mental health, anxiety, and depressive symptoms. Paired sample t-tests were used to assess differences in physical activity and sedentary behaviour before and during lockdown. Multiple linear regressions were used to investigate associations between changes in physical activity and changes in mental and physical health during lockdown. 267 (wave1) and 110 participants (wave2; 2 weeks later) were recruited. Lockdown resulted in higher time spent in walking and moderate physical activity (~10min/day) and in sedentary behaviour (~75min/day), compared to pre COVID-19. Increased physical activity during leisure time from week 2 to week 4 of lockdown was associated with improved physical health (ß=.24, p=.002). Additionally, an increase in sedentary behaviour during leisure time was associated with poorer physical health (ß=-.35, p=.002), mental health (ß=-.25, p=.003), and subjective vitality (ß=-.30, p=.004). Ensuring sufficient levels of physical activity and reducing sedentary time can play a vital role in helping people to cope with a major stressful event, such as the COVID-19 pandemic.

Solving the Puzzle of Cognitive Reserve Effects on Cognitive Decline: The Importance of Considering Functional Impairment.

AIMS: We investigated whether the longitudinal relation between cognitive reserve accumulated across the lifespan and rate of cognitive decline over 6 years differed by the individual's degree of functional impairment. METHODS: We analyzed longitudinal data from 897 older adults (M = 74.33 years) tested on the Trail Making Test (TMT) in 2 waves 6 years apart. RESULTS: There was a significant interaction of functional impairment with cognitive reserve on latent change in cognitive functioning. Specifically, with no functional impairment in the first wave of assessment, greater cognitive reserve accumulated across the lifespan significantly predicted a reduced cognitive decline over 6 years (i.e., smaller increase in TMT completion time). In contrast, with certain functional impairment (in at least some activities) in the first wave, greater cognitive reserve build-up predicted a steeper cognitive decline (i.e., larger increase in TMT completion time). CONCLUSION: Individuals with greater cognitive reserve accumulated across the lifespan show a reduced cognitive decline if they still have relatively little functional impairment, while they will show a steeper decline (compared to individuals with less cognitive reserve) as soon as functional impairment becomes substantial.

Cognitive resources moderate the adverse impact of poor perceived neighborhood conditions on self-reported physical activity of older adults.

Poor neighborhood conditions are associated with lower levels of physical activity for older adults but socio-ecological models posit that physical activity depends on both environmental and individual factors. Older adults' ability to overcome environmental barriers to physical activity may partially rely on cognitive resources. However, evidence on the moderating role of these cognitive resources in the associations between environmental barriers and physical activity is still lacking. We analyzed cross-national and longitudinal data on 28,393 adults aged 50 to 96 years as part of the SHARE. Lack of access to services and neighborhood nuisances were used as indicators of poor neighborhood conditions. Delayed recall and verbal fluency were used as indicators of cognitive resources. Confounder-adjusted generalized estimation equations were conducted to test associations between neighborhood conditions and self-reported moderate physical activity, as well as the moderating role of cognitive resources. Results showed that poor neighborhood conditions reduced the odds of engagement in physical activity. Cognitive resources robustly reduced the adverse influence of poor neighborhood conditions on physical activity. Participants with lower cognitive resource scores showed lower odds of engaging in physical activity when neighborhood conditions were poorer, whereas these conditions were not related to this engagement for participants with higher cognitive resource scores. These findings suggest that cognitive resources can temper the detrimental effect of poor neighborhood conditions on physical activity. Public policies should target both individual and environmental factors to tackle the current pandemic of physical inactivity more comprehensively.

The effects of acute exercise on visuomotor adaptation, learning, and inter-limb transfer.

Pairing an acute bout of lower-limb cycling exercise with skilled motor practice enhances acquisition and learning. However, it is not known whether an acute bout of exercise enhances a specific form of motor learning, namely motor adaptation, and if subsequent inter-limb transfer of this adaptation is enhanced. Seventeen young healthy participants performed a bout of cycling exercise and rest, on separate days, prior to right-arm reaching movements to visual targets under 45° rotated feedback of arm position (acquisition), followed by an immediate test of inter-limb transfer with the untrained left arm. After a 24-h delay, participants returned for a no-exercise retention test using the right and left arm with the same rotated visual feedback as acquisition. Results demonstrated that exercise enhanced right-arm adaptation during the acquisition and retention phases, and transiently enhanced aspects of inter-limb transfer, irrespective of usual levels of physical activity. Specifically, exercise enhanced movement accuracy, decreased reaction and movement time during acquisition, and increased accuracy during retention. Exercise shortened reaction time during the inter-limb transfer test immediately after right-arm acquisition but did not influence left-arm performance assessed at retention. These results indicate that an acute bout of exercise before practice enhances right-arm visuomotor adaptation (acquisition) and learning, and decreases reaction time during untrained left arm performance. The current results may have implications for the prescription of exercise protocols to enhance motor adaptation for healthy individuals and in clinical populations.

Association between Adverse Childhood Experiences and Muscle Strength in Older Age.

BACKGROUND: Muscle weakness - a biomarker of health - may have its origins in early life and be related to factors such as adverse childhood experiences (ACE), which refer to a set of early-life traumatic and stressful psychosocial events out of the child's control. To date, evidence of an association between ACE and muscle strength in older age is lacking. -Objective: Here, we assessed the associations between ACE during the first 15 years of life and the risk of low muscle strength (LMS) later in life. We also examined whether adult-life socioeconomic circumstances (i.e., educational attainment, main occupational position, and satisfaction with household financial situation) and unhealthy behaviors (i.e., physical inactivity, unhealthy eating, smoking, and high level of alcohol consumption) explained this association. METHODS: We used data from the Survey of Health, Ageing, and Retirement in Europe, a 12-year cohort study with 6 -repeated measurements between 2004 and 2015. Muscle strength was measured using a handheld dynamometer. Confounder-adjusted logistic mixed-effect models were used to examine the associations between ACE (child in care, parental death, parental mental illness, parental drinking, period of hunger, or property taken away) and the risk of LMS in older age. -Results: 24,179 participants (96,372 observations; 13,477 women; aged 50-96 years) living in 14 countries were included. LMS increased with age for both genders. For women, there was a gradual increase in the risk of LMS with the number of experienced ACE (ORs = 1.22 for 1 ACE, 1.74 for ≥2 ACE compared to no ACE). However, there was no significant association among men. This association was only slightly attenuated when adjusting for socioeconomic circumstances and unhealthy behaviors in adulthood. CONCLUSIONS: ACE are associated with later-life muscle weakness among women. These associations were not compensated by the adoption of healthy behaviors or an improvement in socioeconomic circumstances in adulthood. These results suggest that tackling these early-life risk factors in women could promote long-term grip strength, a biomarker of aging.

Childhood socioeconomic circumstances and disability trajectories in older men and women: a European cohort study.

Background: We observed a lack of population-based longitudinal research examining the association of disadvantaged childhood socioeconomic circumstances (CSC) and disability [activities of daily living (ADL) and instrumental activities of daily living (IADL)] in older age, and whether socioeconomic attainments in adulthood can compensate for a poor socioeconomic start in life. Methods: Data on 24 440 persons aged 50-96 in 14 European countries (Survey of Health, Ageing and Retirement in Europe) were used to measure the associations between CSC and limitations with ADL and with IADL, using mixed-effects logistic regression models. Models stratified by gender were adjusted for education during young adulthood, main occupation during middle age, ability to make ends meet during old age and potential confounding and control variables. Results: Risks of ADL and IADL limitations increased with age and were different between women and men. For women, a gradient across CSC strata was observed, showing that the more disadvantaged the CSC, the higher the risk of ADL and IADL limitations in old age, even after adjustment for adult socioeconomic indicators. For men, the association between CSC and disability was mediated by the main occupation in middle age and the ability to make ends meet at older age. Conclusion: Women who grew up in socioeconomically disadvantaged households were at higher risk of disability in older age and this disadvantage was not attenuated by favourable adult socioeconomic conditions. Men were more likely to make up for a disadvantaged start in adulthood.

Association of early- and adult-life socioeconomic circumstances with muscle strength in older age.

Background: socioeconomic circumstances (SEC) during a person's lifespan influence a wide range of health outcomes. However, solid evidence of the association of early- and adult-life SEC with health trajectories in ageing is still lacking. This study assessed whether early-life SEC are associated with muscle strength in later life-a biomarker of health-and whether this relationship is caused by adult-life SEC and health behaviours. Methods: we used data from the Survey of Health Ageing and Retirement in Europe, a 12-year population-based cohort study with repeated measurement in six waves (2004-15) and retrospective collection of life-course data. Participants' grip strength was assessed by using a handheld dynamometer. Confounder-adjusted logistic mixed-effect models were used to examine the associations of early- and adult-life SEC with the risk of low muscle strength (LMS) in older age. Results: a total of 24,179 participants (96,375 observations) aged 50-96 living in 14 European countries were included in the analyses. Risk of LMS was increased with disadvantaged relative to advantaged early-life SEC. The association between risk of LMS and disadvantaged early-life SEC gradually decreased when adjusting for adult-life SEC for both sexes and with unhealthy behaviours for women. After adjusting for these factors, all associations between risk of LMS and early-life SEC remained significant for women. Conclusion: early-life SEC are associated with muscle strength after adjusting for adult-life SEC and behavioural lifestyle factors, especially in women, which suggests that early life may represent a sensitive period for future health.

Pre-stroke physical activity matters for functional limitations: A longitudinal case-control study of 12,860 participants.

Objective: In the chronic phase after a stroke, limitations in activities of daily living (ADLs) and instrumental ADL (IADLs) initially plateau before steadily increasing. The benefits of pre-stroke physical activity on these limitations remain unclear. To clarify this relationship, we examined the effect of physical activity on the long-term evolution of functional limitations in a cohort of stroke survivors and compared it to a cohort of matched stroke-free adults. Methods: Longitudinal data from 2,143 stroke survivors and 10,717 stroke-free adults aged 50 years and older were drawn from a prospective cohort study based on the Survey of Health, Ageing and Retirement in Europe (2004-2022; 8 data collection waves). Physical activity was assessed in the pre-stroke wave. Functional limitations were assessed in the post-stroke waves. Each stroke survivor was matched with 5 stroke-free adults who had similar propensity scores computed on the basis of key covariates, including baseline age, sex, body mass index, limitations in ADL and IADL, chronic conditions and country of residence, before any of the participants from either cohort had experienced a stroke. Results: Results showed an interaction between stroke status and physical activity on ADL limitations (b = -0.076; 95% CI = -0.142 to -0.011), with the effect of physical activity being stronger in stroke survivors (b = -0.345, 95% CI = -0.438 to -0.252) than in stroke-free adults (b = -0.269, 95% CI = -0.269 to -0.241). Conclusion: The beneficial effect of pre-stroke physical activity on ADL limitations after stroke is stronger than its effect in matched stroke-free adults followed for a similar number of years. Impact: Physical activity, an intervention within the physical therapist's scope of practice, is effective in reducing the risk of functional dependence after stroke. Moreover, pre-stroke levels of physical activity can inform the prognosis of functional dependence in stroke survivors.

Physical activity matters for everyone's health, but individuals with multimorbidity benefit more.

Multimorbidity, defined as the presence of two or more chronic conditions, is increasingly prevalent and is a major contributor to ill health in old age. Physical activity (PA) is a key protective factor for health and individuals with multimorbidity could particularly benefit from engaging in PA. However, direct evidence that PA has greater health benefits in people with multimorbidity is lacking. The objective of the present study was to investigate whether the associations between PA and health were more pronounced in individuals with (vs. without) multimorbidity. We used data from 121,875 adults aged 50 to 96 years (mean age = 67 ± 10 years, 55% women) enrolled in the Survey of Health, Ageing and Retirement in Europe (SHARE). Multimorbidity and PA were self-reported. Health indicators were assessed using tests and validated scales. Variables were measured up to seven times over a 15-year period. Confounder-adjusted linear mixed-effects models were used to investigate the moderating role of multimorbidity on the associations of PA with the levels and trajectories of health indicators across aging. Results showed that multimorbidity was associated with declines in physical, cognitive, and mental health, as well as poorer general health. Conversely, PA was positively associated with these health indicators. We found a significant interaction between multimorbidity and PA, revealing that positive associations between PA and health indicators were strengthened in people with multimorbidity - although this stronger association became less pronounced in advanced age. These findings suggest that the protective role of PA for multiple health indicators is enhanced in individuals with multimorbidity.

Relationship between reward-related brain activity and opportunities to sit.

The present study tested whether energy-minimizing behaviors evoke reward-related brain activity that promotes the repetition of these behaviors via reinforcement learning processes. Fifty-eight healthy young adults in a standing position performed a task where they could earn a reward either by sitting down or squatting while undergoing electroencephalographic (EEG) recording. Reward-prediction errors were quantified as the amplitude of the EEG-derived reward positivity. Results showed that reward positivity was larger on reward versus no reward trials, confirming the validity of our paradigm to measure evoked reward-related brain activity. However, results showed no evidence that sitting (versus standing and squatting) trials led to larger reward positivity. Moreover, we found no evidence suggesting that this effect was moderated by typical physical activity, physical activity on the day of the study, or energy expenditure during the experiment. However, at the behavioral level, results showed that the probability of choosing the stimulus more likely to lead to sitting than standing increased as the number of trials increased. In addition, results revealed that the probability of changing the selected stimulus was higher when the previous trial was a stand trial relative to a sit trial. In sum, neural results showed no evidence supporting the theory that opportunities to minimize energy expenditure are rewarding. However, behavioral findings suggested participants tend to choose the less effortful behavioral alternative and were therefore consistent with the theory of effort minimization (TEMPA).

Social protection expenditure on health in later life in 20 European countries: Spending more to reduce health inequalities.

BACKGROUND: This study aims to examine whether higher social protection expenditure reduces the negative association of life-course socioeconomic disadvantages with subjective and objective health status and trajectories in later life. METHODS: We used SHARE data from participants living in 20 European countries aged 50 to 96. Seven waves allowed to examine the trajectories of health inequalities in later life. We used linear mixed-effects models stratified by sex to examine the association between life-course socioeconomic disadvantage and subjective (self-rated health, SRH, N = 55,443) and objective (grip strength, N = 54,718) health. Cross-level interactions between net social protection expenditure as percentage of gross domestic product and life-course socioeconomic disadvantage tested for the moderating effect of social expenditures on the association of disadvantage with SRH and grip strength in later life. FINDINGS: Higher social protection expenditure reduced socioeconomic health inequalities in both men and women for grip strength, and in women but not men for SRH. For SRH, the health-inequality-reducing effect of social protection expenditure became weaker with increasing age. This was not observed in grip strength. Some separate expenditure functions (disability, family and children) were found to have inequality-widening effects in men's and women's SRH, which were either offset or overcompensated by the other functions. No inequality-widening effects were observed in grip strength. INTERPRETATION: Higher social spending reduces life-course socioeconomic inequalities in women's subjective health and in men's and women's objective health. However, some specific social protection policies may have the unintentional effect of increasing inequalities in people's evaluation of their own health.

Cognitive functions and physical activity in aging when energy is lacking.

Declines in subjective energy availability and cognitive functions could explain the decrease in physical activity observed across aging. However, how these factors interact remains unknown. Based on the theory of effort minimization in physical activity (TEMPA), we hypothesized that cognitive functions may help older adults to maintain physical activity even when energy availability is perceived as insufficient. This study used data of 104,590 adults from 21 European countries, from the Survey of Health, Ageing and Retirement in Europe (SHARE), including 7 measurement occasions between 2004 and 2017. Cognitive functions were assessed with verbal fluency and delayed recall, using the verbal fluency test and the 10-word delayed recall test. Physical activity and subjective energy availability were self-reported. Results of linear mixed-effects models revealed that cognitive functions moderated the associations between subjective energy availability and physical activity. Moreover, as adults get older, cognitive functions became critical to engage in physical activity regardless the availability of perceived energy. Sensitivity and robustness analyses were consistent with the main results. These results suggest that cognitive functions may help older adults to maintain regular physical activity even when energy for goal pursuit becomes insufficient, but that the protective role of cognitive functions becomes critical at older age, irrespective of the state of perceived energy. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-021-00654-2.

Residential trajectories across the life course and their association with cognitive functioning in later life.

Previous work has found that later life urban-rural differences in cognitive health can be largely explained by indicators of cognitive reserve such as education or occupation. However, previous research concentrated on residence in limited, specific, periods. This study offers a detailed investigation on the association between urban (vs. rural) residence from birth, and cognitive functioning in older age. Using data from the Survey of Health Ageing and Retirement in Europe we created residential trajectories from birth to survey enrolment with a combination of sequence and cluster analysis. Using mixed-effects models, we investigated the association between residential trajectories in early, mid, and later life and three cognitive functioning outcomes: immediate recall, delayed recall, and verbal fluency. In a sample of 38,165 participants, we found that, even after accounting for differences related to education and occupation, rural (vs. urban) residence in early life remained associated with poorer cognitive performance later in life. This suggests that growing up in rural regions leads to a long-term disadvantage in cognitive functioning. Thus, public health policies should consider that urban-rural inequalities in early life may have long-lasting associations with inequalities in cognitive health in old and very old age.

How Welfare Regimes Moderate the Associations Between Cognitive Aging, Education, and Occupation.

OBJECTIVES: Previous studies have shown the importance of individual markers of cognitive reserve, such as education and occupation, for cognitive health in old age. However, there has been only little investigation so far on how this relationship varies across contexts. METHODS: We analyzed data from the Survey of Health, Ageing, and Retirement in Europe, using second-order latent growth models, to assess the moderating role of welfare regimes on the relationship between education and occupation skill level in explaining overall cognitive functioning and decline in old age. Our sample includes 13 European countries using data from 5 regular waves of the survey (2004-2007 and 2011-2015) and 2 retrospective ones (2008-2009 and 2017). Cognitive functioning was modeled as a latent variable measured by immediate and delayed recall, verbal fluency, and numeracy. RESULTS: 74,193 participants were included from the survey. Our analysis showed that the association of education with cognition was weaker overall in Scandinavian countries, but stronger in Southern European countries, relative to Bismarckian ones. However, educational differences in the decline of cognition were more pronounced only in Scandinavian compared to Bismarckian countries. Additionally, higher-skilled occupations in Scandinavian countries had better overall functioning compared to the same occupations in Bismarckian countries, but there was no difference in the decline in cognitive functioning. DISCUSSION: Our findings indicate that the associations of cognitive functioning and its decline with individuals' cognitive reserve markers (education and occupational skill level) vary according to welfare regimes, showing the importance of contextual factors in cognitive aging processes.

Evolution of physical activity habits after a context change: The case of COVID-19 lockdown.

OBJECTIVE: Habits, defined as well-learned associations between cues and behaviours, are essential for health-related behaviours, including physical activity (PA). Despite the sensitivity of habits to context changes, little remains known about the influence of a context change on the interplay between PA habits and behaviours. We investigated the evolution of PA habits amidst the spring COVID-19 lockdown, a major context change. Moreover, we examined the association of PA behaviours and autonomous motivation with this evolution. DESIGN: Three-wave observational longitudinal design. METHODS: PA habits, behaviours, and autonomous motivation were collected through online surveys in 283 French and Swiss participants. Variables were self-reported with reference to three time-points: before-, mid-, and end-lockdown. RESULTS: Mixed effect modelling revealed a decrease in PA habits from before- to mid-lockdown, especially among individuals with strong before-lockdown habits. Path analysis showed that before-lockdown PA habits were not associated with mid-lockdown PA behaviours (ß = -.02, p = .837), while mid-lockdown PA habits were positively related to end-lockdown PA behaviours (ß = .23, p = .021). Autonomous motivation was directly associated with PA habits (ps < .001) and withto before- and mid-lockdown PA behaviours (ps < .001) (but not with end-lockdown PA behaviours) and did not moderate the relations between PA behaviours and habits (ps > .072). CONCLUSION: PA habits were altered, and their influence on PA behaviours was impeded during the COVID-19 lockdown. Engagement in PA behaviours and autonomous motivation helped in counteracting PA habits disruption.

Relationship between decline in cognitive resources and physical activity.

OBJECTIVE: This study aimed to test whether the level of cognitive resources explains engagement in physical activity across aging and whether the age-related decline of cognitive resources precede the decline in physical activity. METHOD: Data from 105,206 adults aged 50 to 90 years from the Survey of Health, Ageing, and Retirement in Europe (SHARE) were used in adjusted linear mixed models to examine whether the engagement in moderate physical activity and its evolution across aging were dependent on cognitive resources. Cognitive resources and physical activity were measured 5 times over a 12-year period. Delayed recall, verbal fluency, and the level of education were used as indicators of cognitive resources. The frequency of engagement in moderate physical activity was self-reported. Dynamic structural equation models (SEM) were used to assess the temporal precedence of changes in cognitive resources and physical activity. RESULTS: Lower cognitive resources were associated with lower levels and steeper decreases in moderate physical activity across aging. Results further revealed a time-ordered effect with a stronger influence of cognitive resources (delayed recall and verbal fluency) on subsequent changes in moderate physical activity than the opposite. CONCLUSION: These findings suggest that, after age 50, the level of engagement in moderate physical activity and its trajectory depend on the availability of cognitive resources. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Physically active individuals look for more: An eye-tracking study of attentional bias.

Attentional capture by exercise-related stimuli is important for the regulation of physical activity. Attentional processing underlying this capture has been investigated with indirect behavioral measures based on reaction times. To investigate more direct measures of visual spatial attention toward physical activity (vs. inactivity) stimuli, we used eye-tracking and a visual dot probe task in 77 young adults with various level of physical activity. Reaction times to detect a dot appearing in the area previously occupied by a physical activity (vs. inactivity) stimulus were an indirect measure of attentional bias. The first picture gaze and viewing time were more direct measures of attentional orienting and attentional engagement, respectively. Pupil dilation was an indicator of arousal. Reaction times revealed a two-way interaction between the location of the dot and participants' usual level of physical activity. Only participants with a high level of physical activity more quickly detected a dot when it appeared in the area previously occupied by a physical activity stimulus. Eye-tracking results showed greater odds of first gazing at physical activity stimuli and for a longer time, and a greater decrease in pupil size when viewing physical activity stimuli when usual level of physical activity was moderate or high, but not low. The variance explained in the outcomes ranged from 13.9% (pupil dilation) to 40% (reaction times). Overall, as hypothesized, compared to less physically active participants, participants who were more physically active demonstrated indirect (reaction times) and direct (first gaze, viewing time) evidence of a more pronounced attentional bias toward physical activity. Physical activity stimuli biased attention, with a pronounced effect when the level of physical activity was higher. These findings suggest that physical activity stimuli are relevant to the current concerns of moderately and highly active individuals.

Adverse Childhood Experiences, Depressive Symptoms, Functional Dependence, and Physical Activity: A Moderated Mediation Model.

BACKGROUND: Adverse childhood experiences, depressive symptoms, and functional dependence are interrelated. However, the mechanisms underlying these associations remain unclear. The authors investigated the potential of depressive symptoms to mediate the effect of adverse childhood experiences on functional dependence in older age and whether physical activity moderated this mediation. METHOD: Data from 25,775 adults aged 62 (9) years from the Survey of Health Ageing and Retirement in Europe were used in adjusted linear mixed-effects models to test whether depressive symptoms mediated the associations between adverse childhood experiences and functional dependence in activities of daily living (ADL) and instrumental ADL (IADL) and whether physical activity moderated these mediations. RESULTS: The results showed a graded association between the number of adverse childhood experiences (0 vs 1 and 0 vs ≥2) and the number of functional limitations in both ADL (bs = 0.040 and 0.067) and IADL (bs = 0.046 and 0.076). These associations were mediated by depressive symptoms. Physical activity reduced the effect of adverse childhood experiences on depressive symptoms (bs = -0.179 and -0.515) and tempered the effect of depressive symptoms on functional dependence both in ADL (b = -0.073) and IADL (b = -0.100). As a result of these reductions, the effect of adverse childhood experiences and depressive symptoms on functional dependence in ADL (Ps > .081) and IADL (Ps > .528) was nonsignificant in physically active participants. CONCLUSIONS: These findings suggest that, after age 50, engaging in physical activity more than once a week protects functional independence from the detrimental effects of adverse childhood experiences and depression. In inactive individuals, the detrimental effects of adverse childhood experiences on functional dependence are mediated by depressive symptoms.

Life Course Socioeconomic Conditions and Frailty at Older Ages.

OBJECTIVES: This article aimed to assess associations of childhood socioeconomic conditions (CSC) with the risk of frailty in old age and whether adulthood socioeconomic conditions (ASC) influence this association. METHODS: Data from 21,185 individuals aged 50 years and older included in the longitudinal Survey of Health, Ageing, and Retirement in Europe were used. Frailty was operationalized as a sum of presenting weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted multilevel logistic regression models were used to analyze associations of CSC and ASC with frailty. RESULTS: While disadvantaged CSC was associated with higher odds of (pre-)frailty in women and men (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.34, 2.24; OR = 1.84, 95% CI 1.27, 2.66, respectively), this association was mediated by ASC. Personal factors and demographics, such as birth cohort, chronic conditions, and difficulties with activities of daily living, increased the odds of being (pre-)frail. DISCUSSION: Findings suggest that CSC are associated with frailty at old age. However, when taking into account ASC, this association no longer persists. The results show the importance of improving socioeconomic conditions over the whole life course in order to reduce health inequalities in old age.