Life Course Origins of Frailty in Later Life

Frailty, generally characterized as a clinical state of increased vulnerability resulting from age-related decline in reserve and function across multiple physiologic systems, has been gaining attention in recent years due to its high correlates with a number of poor health outcomes including falls, hospitalization, and mortality. Although policy makers, health practitioners, and researchers have acknowledged that frailty is a major public health issue, few have investigated the life course predictors of this devastating and costly syndrome. The purpose of this dissertation is (1) to identify the early and later-life predictors of initial frailty and frailty growth over time among older US adults, (2) to examine if childhood exposures influence frailty directly and/or indirectly through adult risks and resources, and (3) to examine the role that social relationships play in frailty trajectories among older adults. Drawing from cumulative inequality theory, this dissertation uses longitudinal data from the Health and Retirement Study (HRS) to examine the effects of childhood exposures, adult risks/resources, and social relationships on frailty trajectories among adults 65 and older. The empirical investigation is presented in two main chapters.