Being born in the aftermath of World War II increases the risk for health deficit accumulation in older age: results from the KORA-Age study
Being born in the aftermath of World War II increases the risk for health deficit accumulation in older age: results from the KORA-Age study
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DOI：
10.1007/s10654-019-00515-4
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发表时间：
2019-07-01
影响因子：
13.6
通讯作者：
Grill, Eva
中科院分区：
文献类型：
--
作者：
Stephan, Anna-Janina;Strobl, Ralf;Grill, Eva
发病趋势可能与关键发育年龄的队列经历有关。我们的目的是比较第二次世界大战后德国早期重建和粮食危机时期（ERFC）前（1937- 1945年6月）、期间（1945年6月- 1948年6月）和之后（1948年6月-1950年）处于关键发育年龄的65-71岁老人的健康状况。数据来自德国南部奥格斯堡地区合作卫生研究(KORA)-年龄研究。我们使用了出生在1937-1943年的2008年基线样本和出生在1944-1950年的2015年浓缩样本。使用虚弱指数（FI）评估健康状况为累积健康缺陷的数量。根据临界发育年龄（妊娠期和头2岁）和ERFC期的共同出现来定义队列。采用广义线性模型分析队列、年龄和性别对老年健康状况的影响。我们纳入了590名战前和战争（PWW）参与者（53%为男性），475名（51%为男性）ERFC参与者和171名货币改革（PCR）后队列参与者（46%为男性）。校正协变量后，与PWW组相比，ERFC组的FI水平显著高于PWW组（比值1.14,CL[1.06, 1.23]），而PCR组的FI水平则不显著高于PWW组（比值1.06,CL[0.94, 1.20]）。在ERFC期间处于关键发育年龄会增加65-71岁成年人的FI水平。协变量没有解释这些影响，这表明在ERFC期间处于关键发育年龄对老年健康有直接的有害影响。在PCR队列中未发现德国发病率的增加。
Morbidity trends may result from cohort experiences in critical developmental age. Our objective was to compare the health status of 65-71year-olds who were in critical developmental age before (1937-June 1945), during (June 1945-June 1948) and after (June 1948-1950) the early reconstruction and food crisis (ERFC) period in Germany following World War II. Data originate from the KORA (Cooperative Health Research in the Region of Augsburg)-Age study in Southern Germany. We used the 2008 baseline sample born 1937-1943 and the 2015 enrichment sample born 1944-1950. Health status was assessed as the number of accumulated health deficits using a Frailty Index (FI). Cohorts were defined based on co-occurrence of critical developmental age (gestation and the first 2years of life) and the ERFC period. Cohort, age and sex effects on older-age health status were analyzed using generalized linear models. We included 590 (53% male) pre-war and war (PWW), 475 (51% male) ERFC and 171 post-currency reform (PCR) cohort participants (46% male). Adjusted for covariates, FI levels were significantly higher for the ERFC (Ratio 1.14, CL [1.06, 1.23]) but not for the PCR (Ratio 1.06, CL [0.94, 1.20]) as compared to the PWW cohort. Being in critical developmental age during the ERFC period increased FI levels in adults aged 65-71years. Covariates did not explain these effects, suggesting a direct detrimental effect from being in critical developmental age during the ERFC period on older-age health. This expansion of morbidity in Germany was not detected in the PCR cohort.