Life course and intrinsic ability in Brazilian adults and older adults: a mediation analysis

To analyze the direct and indirect associations between adverse life course conditions and impairment of intrinsic capacity in Brazilians aged 50 years or older.

An analytical cross-sectional study using data from the second wave of the Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil) (n = 4,817). Intrinsic capacity was assessed across five domains (cognition, vitality, mobility, psychological aspects, and sensory aspects) and was considered impaired when three or more domains were affected. Childhood adversities included parental illiteracy, lack of running water at home, and food insecurity. Educational attainment and income in adulthood were considered mediating variables. Path analysis was used.

Childhood adversities had significant direct and indirect effects on the impairment of intrinsic capacity. These effects were mediated by lower educational attainment and income in adulthood. Educational attainment stood out as a central mediator, exerting a direct protective effect on intrinsic capacity and an indirect effect through its influence on income.

The findings reinforce the relevance of the life-course perspective for understanding inequalities in aging and indicate educational attainment as a priority target for interventions aimed at promoting healthy aging in the Brazilian context.