University of Oulu

Markus J Haapanen, MD, PhD, Juulia Jylhävä, PhD, Lauri Kortelainen, Tuija M Mikkola, PhD, Minna Salonen, PhD, Niko S Wasenius, PhD, Eero Kajantie, MD, PhD, Johan G Eriksson, MD, DMSc, Mikaela B von Bonsdorff, PhD, Early-Life Factors as Predictors of Age-Associated Deficit Accumulation Across 17 Years From Midlife Into Old Age, The Journals of Gerontology: Series A, Volume 77, Issue 11, November 2022, Pages 2281–2287,

Early-life factors as predictors of age-associated deficit accumulation across 17 years from midlife into old age

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Author: Haapanen, Markus J.1,2,3; Jylhävä, Juulia3,4; Kortelainen, Lauri1;
Organizations: 1Folkhälsan Research Center, Helsinki, Finland
2Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
4Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Tampere, Finland
5Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
6Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
7PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
8Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
9Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
10Yong Loo Lin School of Medicine, Department of Obstetrics and Gynecology and Human Potential Translational Research Programme, National University Singapore, Singapore
11Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
12Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 3.2 MB)
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Language: English
Published: Oxford University Press, 2022
Publish Date: 2023-05-05


Background: Early-life exposures have been associated with the risk of frailty in old age. We investigated whether early-life exposures predict the level and rate of change in a frailty index (FI) from midlife into old age.

Methods: A linear mixed model analysis was performed using data from 3 measurement occasions over 17 years in participants from the Helsinki Birth Cohort Study (n = 2 000) aged 57–84 years. A 41-item FI was calculated on each occasion. Information on birth size, maternal body mass index (BMI), growth in infancy and childhood, childhood socioeconomic status (SES), and early-life stress (wartime separation from both parents) was obtained from registers and health care records.

Results: At age 57 years the mean FI level was 0.186 and the FI levels increased by 0.34%/year from midlife into old age. Larger body size at birth associated with a slower increase in FI levels from midlife into old age. Per 1 kg greater birth weight the increase in FI levels per year was −0.087 percentage points slower (95% confidence interval = −0.163, −0.011; p = 0.026). Higher maternal BMI was associated with a higher offspring FI level in midlife and a slower increase in FI levels into old age. Larger size, faster growth from infancy to childhood, and low SES in childhood were all associated with a lower FI level in midlife but not with its rate of change.

Conclusions: Early-life factors seem to contribute to disparities in frailty from midlife into old age. Early-life factors may identify groups that could benefit from frailty prevention, optimally initiated early in life.

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Series: Journals of gerontology. A, Biological sciences and medical sciences
ISSN: 1079-5006
ISSN-E: 1758-535X
ISSN-L: 1079-5006
Volume: 77
Issue: 11
Pages: 2281 - 2287
DOI: 10.1093/gerona/glac007
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This work was supported by Medicinska Understödföreningen Liv och Hälsa.
Copyright information: © The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.