• This is a major breakthrough 17 April 2018 | View comments

  • 17th April 2018 | By David Jolley

    This is a major breakthrough: application of the principles identified here will improve life for so many people.

    Shamefully I had not known about the LIFEPATH consortium https://www.lifepathproject.eu/ until I came across a paper in last week’s BMJ from Silvia Stringhini and colleagues: Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study https://www.bmj.com/content/360/bmj.k1046

    The paper reads as something written by a committee whose languages span the globe – and so it is. They have brought together and ‘harmonised’ the data from 37 cohort studies for 24 countries to examine the hypothesis that socioeconomic status is at least as powerful in determining ability and self-care in later life (and survival), as recognised risk factors.

    WHO is aiming to reduce premature deaths by 25% before 2025 and is targeting: alcohol (did you see front page news on Friday that heavy drinking reduces life expectation? https://www.theguardian.com/science/2018/apr/12/one-extra-glass-of-wine-will-shorten-your-life-by-30-minutes ). This is not a new insight – we have known the ‘alcohol is a self-limiting illness’ for many years.

    Insufficient physical activity, tobacco, high blood pressure, excessive salt intake, diabetes, and obesity.

    The LIFEPATH consortium asks how socioeconomic circumstances compare with these disease risk factors in predicting the onset of disability and death. They find that socioeconomic circumstances are as powerful a predictor as any of the more often cited and targeted risk factors.

    This is so important because it gives the opportunity for countries to manipulate their taxes, services and job opportunities to improve the prospects for the least well off, to produce a healthier population. It seems very likely that we have stumbled on an understanding that it is this measure which underpins all the other rises in risk of impairment in older age: better economic status will reduce the likelihood of excessive use of alcohol, tobacco, salt and food. It will give time and money to take exercise. The incidence of diabetes will be reduced.

    We are reminded of the finding that the incidence of dementia has fallen where economic circumstances have improved, but risen where they have deteriorated. http://www.cam.ac.uk/research/news/new-cases-of-dementia-in-the-uk-fall-by-20-over-two-decades

    ‚ÄčThis is a real breakthrough in understanding… We need now the will to use it.

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