title: Impact of socioeconomic position on frailty trajectories in 10 European countries: evidence from the Survey of Health, Ageing and Retirement in Europe (2004-2013).
abstract: Whether or not, and how, health inequalities change throughout older age is currently under debate. The goal of this study was to assess the net impact of education, occupational class, income and wealth on frailty trajectories among older adults in Continental Europe.
  
  
  
  We modelled frailty index trajectories within a repeated cohort design among the community-dwelling population (50+) in 10 countries, using growth curve models based on 54 036 observations from 20 965 respondents in 4 waves (2004-2013) of the Survey of Health, Ageing and Retirement in Europe.
  
  
  
  Gaps in frailty due to education, occupational class and wealth continued throughout old age, while the gap due to income, smaller in comparison, converged. Frailty levels were higher and trajectories steeper in later birth cohorts, and the impact of education increased over time. Frailty levels and growth curves were higher in Southern European countries, and results were consistent across countries regarding the continuous effect of education and occupation and more mixed regarding wealth and income.
  
  
  
  Health inequalities due to education, occupational class and wealth tend to persist throughout old age, whereas the negligible effect of income declines with age, which, substantially, highlights the importance of social conditions on the pace of physiological decline in older Europeans and, methodologically, highlights the need to assess multiple measures of socioeconomic position.
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: Erwin
authors.initials: E
authors.lastname: Stolz
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: Hannes
authors.initials: H
authors.lastname: Mayerl
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: Anja
authors.initials: A
authors.lastname: Waxenegger
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: Éva
authors.initials: É
authors.lastname: Rásky
authors.affiliation: Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Freidl
mesh_terms: D000368:Aged; D004522:Educational Status; D005060:Europe; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D009790:Occupations / Q000706:statistics & numerical data; D012923:Social Class
keywords: Epidemiology of ageing; Health inequalities; LONGITUDINAL STUDIES; MULTILEVEL MODELLING; Social and life-course epidemiology