Table 3.

Effects of early-life conditions on adult functionality/disability

Outcomea	Measureb	Category	Effects	Country
At least one ADL	Height (continuous)	Child Nutrition	0.96**	Mexico62
	Current smoking	Adult Lifestyle	1.07
	Heavy drinking	Adult Lifestyle	2.64**
At least one ADL	Never/rarely suffered from severe sickness	Child Health	0.70*** (m), 0.74*** (f)	China72
	Adequate medical service for childhood illnesses	Child SES	0.82* (m), 0.78***(f)
	Father’s occupation professional	Child SES	0.90 (m), 1.17 (f)
	Survival status of parents at age 10	Child SES
		Ref: at least one	1.00
		Both parents alive	1.06 (m), 1.01 (f)
		Missing	1.51*** (m), 1.29** (f)
	Some schooling	Child SES	0.96 (m), 1.03 (f)
	Place of birth (urban)	Child SES	1.01 (m), 1.02 (f)
	Currently smokes	Adult Lifestyle	0.72*** (m), 1.01 (f)
	Currently drinks heavily	Adult Lifestyle	0.67*** (m), 1.05 (f)
	Currently exercises regularly	Adult Lifestyle	0.65*** (m), 0.73*** (f)
At least one ADL	Child health problems + poor child SES	Child Health, SES	2.46–7.54**	LAC69
At least one ADL	Child health problems + poor child SES	Child Health, SES	2.36–10.18**	PR69
At least one ADL	Had both parents alive at age 10	Child Health	0.82**	China74,c
	Lived in urban area	Child SES	1.22*
	Leisure activity index	Adult Lifestyle	0.78***
	Smoked in the past 5 years	Adult Lifestyle	0.95
	Alcoholic use in the past 5 years	Adult Lifestyle	1.00
	Regular exercise in the past 5 years	Adult Lifestyle	1.08
Number of lower body limitations	Went to bed hungry d	Child Nutrition	1.45**	Mexico73
	Health problemse	Child Health	1.28**
	Mother’s education	Child Health, Nutrition	1.00 – none
			0.89* – elementary
			0.69* – Junior high+
	Father’s occupation	Child SES	1.00 – agriculture
			0.82 – office/professional
			0.90 – other non-agricultural
			1.21* – other (child care, occupation not in questionnaire, or did not work)
			0.90 – had no father
	Born high migration state	Child SES	0.83**
	Smoking	Child and Adult Lifestyle	1.45** – start <age 16
			1.12* – start age 16+

ADL, activities of daily living; Gender models noted by: m, males; f, females; SES, socioeconomic status; LAC, Latin American and Caribbean major cities; PR, Puerto Rico.

Notes: Shown are odds ratios that reflect net effects after controlling for covariates that varied from study to study but in most instances included age, gender and education. One study⁶⁹ controlled for adult lifestyle but did not report the results.

^aFunctionality was defined using either ADLs⁹⁵ or the Nagi⁹⁶ items.

Huang et al.⁷³ included eight Nagi items to measure functional performance: difficulty with running a mile, walking several blocks, walking one block, climbing several flights of stairs, climbing one flight of stairs, sitting for two hours, getting up from a chair after sitting for long periods and stooping, kneeling and crouching.

Studies that used ADLs to define functionality differed slightly in the items that comprised ADLs. The Yi et al.⁷² measured functionality using eating, dressing, indoor transferring, using the toilet, bathing and incontinence. Wen and Gu⁷⁴ measured functionality using bathing, dressing, eating, indoor transferring, toileting and incontinence. The LAC ⁶⁹ measured functionally using going across the room, dressing, bathing, eating, getting up and laying down in bed and going to the bathroom.

^bMeasures for nutrition, health, SES and lifestyle were defined slightly differently from country to country.

Measures of childhood nutrition were defined in the following manner: (1) height [continuous (cm)];⁶² and (2) went to bed hungry [yes (no)].⁷³

Measures of childhood health were defined in the following manner: (1) childhood health problems +poor childhood SES [yes (no)];⁶⁹ (2) health problems [yes (no)];⁷³ (3) never/rarely suffered from a severe illness [yes (no)];⁷² and (4) mother’s education [no school (reference group), some elementary, completed elementary, more than elementary].⁷³

Measures of childhood SES were defined in the following manner: (1) poor childhood SES [yes (no)];⁶⁹ (2) adequate medical service for childhood illnesses [yes (no)];⁷² (3) father’s occupation professional [yes (no)];⁷² (4) father’s occupation [agricultural (reference group), professional, other non-agricultural, housework/other];⁷³ (5) survival status of parents at respondent’s age 10 [at least one parent died (reference group), both living, missing];⁷² (6) had both parents alive at age 10 [yes (no)];⁷⁴ (7) some schooling [yes (no)];⁷² (8) place of birth – urban [yes (no)];^{72, 74} and (9) born in high migration state [yes (no)].⁷³

Measures of adult lifestyle were defined in the following manner: (1) smoking: current smoker [yes (no)];^{62, 72} never smoked (reference group), started smoking before age 16, started smoking at age 16 or older;⁷³ smoked in the past 5 years [yes (no)];⁷⁴ (2) drinking: heavy drinker (reports 5+ drinks per day in the past year);⁶² drinks heavily [defined as 400 g of beer per day (yes (no))];⁷² drank in the past 5 years [yes (no)];⁷⁴ (3) exercising: exercises regularly [yes (no)];⁷² regularly exercised in the past 5 years [yes (no)];⁷⁴ and (4) leisure activity index (an index developed to encompass a range of activities shown to impact health conditions at older ages including gardening, raising pets, outdoor activities, reading, playing cards, listening to radio, watching television and social activities).⁷⁴

^cOnly select variables were included from Wen and Gu⁷⁴ due to space constraints.

^dSome measures shown in the table can also be interpreted as measures of childhood SES. Mexico⁷³ interpreted health problems and went to bed hungry as indicators of childhood nutritional deprivation and poor health.

^eHealth problems in Huang et al.⁷³ included at least one of the following: tuberculosis, rheumatic fever, polio, typhoid fever or a serious blow to the head that made the respondent faint.

^*P <0.05;

^**P <0.01;

^***P <0.001.