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Life course epidemiology and analysis 

Life course epidemiology and analysis
Chapter:
Life course epidemiology and analysis
Author(s):

Diana Kuh

, Yoav Ben-Shlomo

, Kate Tilling

, and Rebecca Hardy

DOI:
10.1093/med/9780199661756.003.0123
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date: 18 October 2019

A life course approach in epidemiology investigates the biological, behavioural and social pathways that link physical and social exposures and experiences during gestation, childhood, adolescence and adult life, and across generations, to later life health and health inequalities. From an original focus on investigating early life factors for adult chronic diseases, the field has widened to include the study of how factors acting across life, independently, cumulatively and interactively, influence a wide range of health outcomes, and the natural history and physiological trajectory of biological systems, including the ageing process. While there is increasing evidence that factors earlier in life influence the peak level of function achieved, the role of early relative to later life factors on functional change post maturity is more limited. We elaborate our original life course models and framework to more accurately represent the dynamic interplay of developmental, risk factor (behavioural or environmental) and ageing-related trajectories, taking into account individual variation in response to environmental challenges. We discuss and provide illustrative examples of study designs and statistical methods that can test the life course hypotheses generated by these models and framework. Life course epidemiology will be of a most value to public health if it is able to detect early markers of functional change, and identify subgroups of the population most and least likely to be at risk of accelerated decline, or with more or less capacity for compensation or adaptation.

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