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01.12.2012 | Research | Ausgabe 1/2012 Open Access

International Journal for Equity in Health 1/2012

Longitudinal changes in functional capacity: effects of socio-economic position among ageing adults

International Journal for Equity in Health > Ausgabe 1/2012
Tommi Sulander, Heikki Heinonen, Tuuli Pajunen, Antti Karisto, Pertti Pohjolainen, Mikael Fogelholm
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

TS, HH, TP, AK, PP and MF designed the study. TS and TP did the literature review and wrote the first draft. HH and TS analysed the data and implemented the statistical analysis. HH, TP, AK, PP and MF made in-depth revisions to the first draft and HH made further guidance to the statistical analysis. TS made the final version according to the comments from HH, TP, AK, PP, and MF. TS, HH, TP, AK, and MF had full access to the data, and TS had final responsibility for the submission. All authors read and approved the final manuscript.



Health and functional capacity have improved especially in Western countries over the past few decades. Nevertheless, the positive secular trend has not been able to decrease an uneven distribution of health. The main aim of this study was to follow-up changes in functional capacity among the same people in six years time and to detect whether the possible changes vary according to socio-economic position (SEP). In addition, it is of interest whether health behaviours have an effect on these possible changes.


This longitudinal follow-up study consisted of 1,898 individuals from three birth cohorts (1926–1930, 1936–40, 1946–50) who took part in clinical check-ups and answered to a survey questionnaire in 2002 and 2008. A sub-scale of physical functioning from the RAND-36 was used to measure functional capacity. Education and adequacy of income were used as indicators of socio-economic position. Repeated-measures ANOVA was used as a main method of analysis.


Physical functioning in 2002 and 2008 was poorest among those men and women belonging to the oldest cohort. Functional capacity deteriorated in six years among men in the oldest cohort and among women in all three cohorts. Socio-economic disparities in functional capacity among ageing people existed. Especially lower adequacy of income was most consistently associated with poorer functional capacity. However, changes in functional capacity by socio-economic position remained the same or even narrowed independent of health behaviours.


Socio-economic disparities in physical functioning are mainly incorporated in the level of functioning at the baseline. No widening socioeconomic disparities in functional capacity exist. Partly these disparities even seem to narrow with ageing.
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