Socioeconomic differences in physical disability at older age

BACKGROUND: This study aims to investigate the association between socioeconomic position (SEP) and physical disability at older age, using a framework that incorporates education, social class and wealth. Wave One data from the English Longitudinal Study of Ageing are used. METHODS: Self-reported difficulties with activities of daily living, instrumental activities of daily living and motor skills were combined and categorised into "no disability", "mild disability" and "severe disability". The indicators of SEP used were wealth, education and social class. Multinomial regression was used to assess the associations between SEP and physical functioning reflecting the temporal relationship between education, social class and wealth. RESULTS: Men and women who had the highest levels of wealth, education and social class also had the lowest disability rates. The association was stronger in younger age groups and in men. The association of education with disability, which was found to be significant in the unadjusted models, was attenuated when adjusted for other factors such as occupation or wealth. This supports a temporal model of education feeding into occupation and then wealth. The association of SEP with disability was stronger for men and for men and women in the younger age group. CONCLUSIONS: Socioeconomic circumstances affect the prevalence and scale of physical disability even at older ages. In particular, wealth appears more important as a socioeconomic factor for physical disability than social class or education. Socioeconomic gradients in physical disability are greater for men than for women and for those in the younger age groups.