title: Lifecourse adversity and physical performance across countries among men and women aged 65-74.
abstract: BACKGROUND
  This study examines the associations between lifecourse adversity and physical performance in old age in different societies of North and South America and Europe.
  
  
  METHODS
  We used data from the baseline survey of the International Study of Mobility in Aging, conducted in: Kingston (Canada), Saint-Hyacinthe (Canada), Natal (Brazil), Manizales (Colombia) and Tirana (Albania). The study population was composed of community dwelling people between 65 and 74 years of age, recruiting 200 men and 200 women at each site. Physical Performance was assessed with the Short Physical Performance Battery (SPPB). Economic and social adversity was estimated from childhood adverse events, low education, semi-skilled occupations during adulthood and living alone and insufficient income in old age.
  
  
  RESULTS
  A total of 1995 people were assessed. Low physical performance was associated with childhood social and economic adversity, semi-skilled occupations, living alone and insufficient income. Physical performance was lower in participants living in Colombia, Brazil and Albania than in Canada counterparts, despite adjustment for lifecourse adversity, age and sex.
  
  
  CONCLUSIONS
  We show evidence of the early origins of social and economic inequalities in physical performance during old age in distinct populations and for the independent and cumulative disadvantage of low socioeconomic status during adulthood and poverty and living alone in later life.
authors.affiliation: CNPQ Programa de Pós Graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Brazil.
authors.forename: Ana Carolina Patrício de Albuquerque
authors.initials: AC
authors.lastname: Sousa
authors.affiliation: Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Natal, Brazil.
authors.forename: Ricardo Oliveira
authors.initials: RO
authors.lastname: Guerra
authors.affiliation: École de Santé Publique, Université de Montréal, Montréal, Canada.
authors.forename: Mai
authors.initials: M
authors.lastname: Thanh Tu
authors.affiliation: Department of Family Medicine, Queens University, Kingston, Canada.
authors.forename: Susan P
authors.initials: SP
authors.lastname: Phillips
authors.affiliation: Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.affiliation: École de Santé Publique, Université de Montréal, Montréal, Canada; Centre de Recherche du Centre Hospitalière de l'Université de Montréal (CRCHUM), Montréal, Canada.
authors.forename: Maria-Victoria
authors.initials: MV
authors.lastname: Zunzunegui
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000415:Albania; D001938:Brazil; D002170:Canada; D003105:Colombia; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008016:Life Change Events; D008297:Male; D009790:Occupations; D011203:Poverty; D012307:Risk Factors; D012934:Social Isolation; D012959:Socioeconomic Factors
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