Page 27 - IJPS-11-1

International Journal of
Population Studies A review on early-life determinants of frailty

In addition to food deprivation during childhood, a 3.4.3. Traumatic wartime experience
history of breastfeeding was associated with a lower level of Zimmer et al. (2022) examined the association between
frailty (Maharani et al., 2023). Through the analysis of data traumatic wartime experiences in early-life and later-life
from over half a million middle-aged and older adults from frailty using data from 2447 Vietnamese adults aged at least
UK Biobank, Maharani et al. (2023) found that individuals 60 years from the Vietnam Health and Aging Study. Latent
who were breastfed as babies had a lower frailty index than class analysis was employed to categorize individuals
those without a history of breastfeeding. Breast milk, rich based on the number and kinds of traumatic events that
in nutrients, antibodies, and growth factors contribute they experienced during the American war. It identified
to healthier early-life development, improving muscle nine wartime exposure classes, ranging from extreme to
strength and overall physical function (Lisboa et al., 2021; non-exposed. Individuals who experienced more severe
von Bonsdorff et al., 2011). exposures, such as heavy bombing, direct witnessing
of death, sleep disturbances, and life-threatening fears
3.4. Environmental factors
during wartime, which exhibited higher levels of frailty
Environmental factors during childhood, including compared to those who did not. These findings highlight
domestic violence, neighborhood quality, and traumatic the enduring impact of traumatic wartime experiences
wartime experiences, profoundly impact frailty in old age. on frailty in old age. Dimitriadis et al. (2023) found that
Residing in a safe and supportive home and neighborhood adverse childhood experiences, including exposure to war,
environment during childhood might reduce the risk of were associated with a higher level of frailty index in later
frailty, while exposure to traumatic wartime experiences life based on a sample of older adults in the Netherlands.
in early life was associated with a higher risk of later-life Experiencing traumatic war events in the early life can
frailty. impair an individual’s ability to regulate stress. This
impairment can lead to the accumulation of severe stress,
3.4.1. Home environment which, in turn, disrupts the development of immune
Safe, supportive, and nurturing family relationships and metabolic systems, ultimately accelerating the aging
and home environments are central to children’s and process (Ellis & Del Giudice, 2014; Greenblatt Kimron
adolescents’ development and health. Mian et al. (2022) et al., 2019; Schneiderman et al., 2005).
conducted a cross-sectional study to examine the 4. Concluding remarks
association between early home environment and frailty
among over 27 thousand adults aged 45 – 85 years from Through collective efforts, researchers have identified
the Canadian longitudinal study on aging. Individuals various early-life risk factors for frailty in developed and
experiencing more adverse childhood events, including developing countries and areas. These achievements have
physical abuse, sexual abuse, emotional abuse, neglect, paved the way for a future research agenda on preventing
and exposure to domestic violence, before age 16 had frailty. Four topics merit further discussion in future
elevated levels of frailty later in life. Threat-based early- research. First, there is a need for more comparative
life adversities (e.g., violence) affect health outcomes in studies across different countries and regions to clarify
how social and cultural environments influence the health
later life by accelerating the biological aging processes, impacts of adverse childhood experiences on frailty in later
including expedited pubertal development and accelerated life. A recent study using data from China and Europe has
cellular aging (Colich et al., 2020). shown varying relationships between adverse childhood

3.4.2. Neighborhood quality experiences and frailty in old age (Wang, 2023b). These
variations were observed not only between China and
Li et al. (2020) examined how neighborhood quality Europe but also among different European countries.
during childhood contributed to frailty in old age among Second, most previous studies needed to adequately
over 6000 older Chinese adults. Childhood neighborhood consider the complexity and interconnectedness of different
quality was assessed by four items quantifying whether risk factors in distinct early-life stages. Future research
the neighborhood they lived in before age 17 was safe, needs to adopt new methodologies, such as the polysocial
willing to help, close-knit, and clean and attractive. Each approach (Figueroa et al., 2020; Herrin et al., 2023; Javed
item was dichotomized, and the sum score measured the et al., 2021; Ping et al., 2021; Tang et al., 2023; Tang et al.,
overall neighborhood quality. Individuals with the highest 2023; Zhao et al., 2022), to comprehensively measure the
neighborhood quality had 11.4% and 4.8% lower risk of aggregated effects of various early-life risk factors on frailty
being prefrail and frail than those with the lowest quality, in old age. Third, future research should pay more attention
respectively. to unraveling the mechanisms underlying the associations

Volume 11 Issue 1 (2025) 21 https://doi.org/10.36922/ijps.1982