Background: Intrinsic capacity (IC), defined by the World Health Organization as the aggregate of physical and mental capacities, is a well-established construct in healthy ageing research. However, most studies have examined only a limited number of determinants in isolation, often within a single life-stage and using conventional regression approaches. These approaches cannot capture the interrelated, time-ordered pathways shaping IC across the life course. We aimed to address this by applying a novel Bayesian structural equation modelling (BSEM) approach to estimate direct, indirect, and total effects between temporally ordered exposures and IC outcomes.

Methods: Using data from the Northern Finland Birth Cohort 1966, we modelled IC at ages 31 and 46 years within a forward-directed life-course framework spanning prenatal to mid-life exposures. Exposures comprise approximately 250 individual-level biological, psychosocial, socioeconomic, lifestyle, and work-related variables, as well as environmental-level variables (e.g., greenness index and neighbourhood characteristics).

Results: Preliminary findings from a reduced BSEM analysis including socioeconomic exposures showed that more favourable adult socioeconomic circumstances, including partnership, home ownership, higher occupational status, and more stable employment, predicted higher IC through direct effects. In contrast, associations between earlier-life socioeconomic factors and adulthood IC were mainly indirect, operating through later educational, occupational, and material pathways, consistent with protective pathway models.

Conclusion: These preliminary findings suggest that socioeconomic inequalities in IC are shaped across the life course through cumulative and mediated pathways rather than through direct early-life effects. The conference presentation will report findings from the fully expanded BLSEM, including the wider biopsychosocial and environmental exposome.

Authors:
Leah Hillari, Imperial College London, United Kingdom
Alex Lewin, London School of Hygiene and Tropical Medicine, United Kingdom
Georgina M. Hosang, Queen Mary University of London, United Kingdom
Rozenn Nedelec, University of Oulu, Finland
Marjo-Riitta Järvelin, Imperial College London, United Kingdom

About the Presenter(s)
Leah Hillari is a PhD student at Imperial College London studying biopsychosocial determinants of healthy ageing across the life course using birth cohort data, focusing on intrinsic capacity, functional
ability, and metabolic health.

Connect on Linkedin
https://www.linkedin.com/in/leahhillari?originalSubdomain=de

See this presentation on the full schedule – Thursday Schedule

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