Childhood adversities had significant direct and indirect effects on impairment of intrinsic capacity in Brazilians aged 50 or older, with these effects mediated by lower educational attainment and income in adulthood, and educational attainment emerging as the central mediator.
Key Findings
Results
Childhood adversities were significantly directly associated with impairment of intrinsic capacity in Brazilians aged 50 years or older.
Analytical cross-sectional study using data from the second wave of ELSI-Brasil (n = 4,817).
Childhood adversities included parental illiteracy, lack of running water at home, and food insecurity.
Intrinsic capacity was considered impaired when three or more of five domains (cognition, vitality, mobility, psychological aspects, sensory aspects) were affected.
Path analysis was used to estimate direct and indirect effects.
Results
Childhood adversities also had significant indirect effects on intrinsic capacity impairment through lower educational attainment and income in adulthood.
Educational attainment and adult income were modeled as mediating variables.
The abstract states that effects of childhood adversities were mediated by lower education and income in adulthood.
The abstract does not report specific coefficients or confidence intervals.
Results
Educational attainment was the central mediator, with both a direct protective effect on intrinsic capacity and an indirect effect through income.
Education exerted a direct protective effect on intrinsic capacity.
Education also influenced income, which in turn was linked to intrinsic capacity, giving an indirect pathway.
The authors identify education as standing out among the mediators.
Conclusions
The authors conclude that the findings support a life-course perspective on inequalities in aging and identify educational attainment as a priority target for healthy aging interventions in Brazil.
Interpretation is based on direct and indirect pathways from childhood adversity to older-age intrinsic capacity.
The study is cross-sectional, so the pathways are statistical mediation estimates.
What This Means
This study used data from nearly 5,000 Brazilians aged 50 and older to ask whether hardships in childhood are linked to poorer overall functioning in later life. Functioning was measured as 'intrinsic capacity', which combines thinking skills, energy and vitality, mobility, psychological well-being, and vision and hearing. Childhood hardships were defined as having parents who could not read, lacking running water at home, and experiencing food insecurity.
The researchers found that childhood adversity was linked to lower intrinsic capacity in older age, both directly and indirectly. The indirect link ran through lower education and lower income in adulthood. Education stood out: it appeared to protect intrinsic capacity directly and also to act through its effect on income.
This research suggests that inequalities in how people age may begin early in life and be carried forward through education and income. The authors point to education as an important target for promoting healthy aging in Brazil. Because the study is cross-sectional, it shows associations and statistical pathways rather than proving cause and effect.
Dias M, Borim F, Nunes D, Pereira I, Pagotto V. (2026). Life course and intrinsic ability in Brazilian adults and older adults: a mediation analysis.. Revista de saude publica. https://doi.org/10.11606/s1518-8787.2026060007512