title: Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis.
abstract: BACKGROUND
  Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.
  
  
  RESULTS
  Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.
  
  
  CONCLUSIONS
  Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.
authors.affiliation: Department of Social Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Kate
authors.initials: K
authors.lastname: Birnie
authors.forename: Rachel
authors.initials: R
authors.lastname: Cooper
authors.forename: Richard M
authors.initials: RM
authors.lastname: Martin
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.forename: Avan Aihie
authors.initials: AA
authors.lastname: Sayer
authors.forename: Beatriz E
authors.initials: BE
authors.lastname: Alvarado
authors.forename: Antony
authors.initials: A
authors.lastname: Bayer
authors.forename: Kaare
authors.initials: K
authors.lastname: Christensen
authors.forename: Sung-il
authors.initials: SI
authors.lastname: Cho
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.forename: Janie
authors.initials: J
authors.lastname: Corley
authors.forename: Leone
authors.initials: L
authors.lastname: Craig
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Deary
authors.forename: Panayotes
authors.initials: P
authors.lastname: Demakakos
authors.forename: Shah
authors.initials: S
authors.lastname: Ebrahim
authors.forename: John
authors.initials: J
authors.lastname: Gallacher
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Gow
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
authors.forename: Steven
authors.initials: S
authors.lastname: Haas
authors.forename: Tomas
authors.initials: T
authors.lastname: Hemmingsson
authors.forename: Hazel
authors.initials: H
authors.lastname: Inskip
authors.forename: Soong-nang
authors.initials: SN
authors.lastname: Jang
authors.forename: Kenya
authors.initials: K
authors.lastname: Noronha
authors.forename: Merete
authors.initials: M
authors.lastname: Osler
authors.forename: Alberto
authors.initials: A
authors.lastname: Palloni
authors.forename: Finn
authors.initials: F
authors.lastname: Rasmussen
authors.forename: Brigitte
authors.initials: B
authors.lastname: Santos-Eggimann
authors.forename: Jacques
authors.initials: J
authors.lastname: Spagnoli
authors.forename: John
authors.initials: J
authors.lastname: Starr
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
authors.forename: Holly
authors.initials: H
authors.lastname: Syddall
authors.forename: Per
authors.initials: P
authors.lastname: Tynelius
authors.forename: David
authors.initials: D
authors.lastname: Weir
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Whalley
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Zunzunegui
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
mesh_terms: D000328:Adult; D002648:Child; D018737:Hand Strength; D054624:Health Status Disparities; D006801:Humans; D009043:Motor Activity; D010808:Physical Examination; D012923:Social Class; D016138:Walking