A positive association between hunger in childhood and frailty in old age: Findings from the Chinese longitudinal healthy longevity survey.

BACKGROUND

Childhood hunger not only directly affects the physical and mental health of children and adolescents but also has a long-term negative effect on later health outcomes. In this cross-sectional study, we used a nationally representative Chinese sample to examine the relationship between hunger in childhood and frailty in older adults.

MATERIALS AND METHODS

The data were obtained from the 2018 Chinese Longitudinal Healthy Longevity Survey. The frailty index with 44 health deficits was used to identify frailty. Childhood hunger was measured by the question "Did you often go to bed hungry as a child?" Insurance status was categorized as New Rural Cooperative Medical Scheme (NRCMS), Urban Basic Medical Insurance Scheme (UBMIS), others, and no insurance. Multivariate logistic regression analysis was performed to estimate the adjusted relationship between childhood hunger and frailty.

RESULTS

A total of 7,342 older people aged 65 years and older were analyzed in this study. Older people who experienced childhood hunger were more likely to have frailty than those who did not (OR = 1.13, 95% CI: 1.02-1.26), after adjustment for sociodemographic characteristics, family/social support, socioeconomic status, insurance status, and health behaviors. The association of childhood hunger with frailty was found in the 65-79 years group (OR = 1.21, 95% CI: 1.03-1.43), women (OR = 1.25, 95% CI: 1.08-1.45), individuals with rural residence (OR = 1.16, 95% CI: 1.03-1.31), agricultural work (OR = 1.16, 95% CI: 1.00-1.34), financial dependence (OR = 1.18, 95% CI: 1.02-1.37), and those participating in NRCMS (OR = 1.35, 95% CI: 1.16-1.56). Participants with hunger in childhood who were 80 years or older (OR = 0.80, 95% CI: 0.65-0.98) had lower odds of frailty. NRCMS (OR = 1.42, 95% CI: 1.02-1.98) showed increased odds of childhood hunger-related frailty.

CONCLUSION

Exposure to hunger during childhood is linked to frailty among older adults, and age, financial support, and insurance status may mediate this relationship. Targeted interventions and policies to address frailty in older adults should be implemented.