Group Eriksson and von Bonsdorff

Frailty has its roots in early development

Early life factors contribute to differences in frailty from midlife into old age. Early life factors may help identify groups which may benefit from frailty prevention and thus allow initiating preventive efforts early. Our findings show that the early stages of life are important to health and disease into old age.

Frailty has been defined as a state that is related to the ageing process in which the body gradually loses function in multiple areas. Frail older people have an increased risk of poor health. Recovery from stress factors, including infections and new medications, may be slower or incomplete among frail individuals. Various factors have been linked to an increased risk of frailty, yet the origins of frailty are not well understood. The origins of frailty might lie in early life development because our tissues and organs are highly sensitive during this period. Early life has been shown to influence health and disease in adulthood, but fewer studies track the participants into old age. We investigated whether early life exposures were related to frailty in midlife and its development from midlife into old age.

We studied 2000 men and women who had data available on their early lives. This included information on their mothers’ body mass index (BMI), duration of her pregnancy, the participants’ birth size, size measurements from infancy to childhood, socioeconomic status, and whether they had been evacuated during World War II. This information was gathered and extracted from various national registers and healthcare records. From midlife onwards (ages 57-84 years), we identified certain pre-determined deficits in the participants’ health status. For example, we recorded physical impairments, various symptoms, abnormal laboratory test values, and functioning. These deficits were summarized together into a frailty index. A higher frailty index value corresponds to a higher level of frailty. The frailty index was created on three measurement occasions during the years 2001-2018, thus the follow-up duration of frailty was up to 17 years.

Our results show that early life factors contribute to how frailty evolves later in life. The offspring of mothers with a higher BMI became frail earlier than the offspring of mothers with a lower BMI. Those who weighed less at birth or those with a shorter duration of pregnancy became frail earlier than those weighing more or with longer duration of pregnancy. We observed more frailty in midlife among those who were larger in size as children, experienced accelerated childhood growth, or had a lower childhood socioeconomic status. However, these factors were unrelated to the development of frailty from midlife into old age.

Early life factors contribute to differences in frailty from midlife into old age. Early life factors may help identify groups which may benefit from frailty prevention and thus allow initiating preventive efforts early. Our findings show that the early stages of life are important to health and disease into old age.

Original article:

Early life factors as predictors of age-associated deficit accumulation across 17 years from midlife into old age. Haapanen MJ, Jylhävä J, Kortelainen L, Mikkola TM, Salonen M, Wasenius NS, Kajantie E, Eriksson JG, von Bonsdorff MB. J Gerontol A Biol Sci Med Sci. 2022 Jan 9:glac007. doi: 10.1093/gerona/glac007. Online ahead of print. PMID: 35018457