Journal of Developmental Origins of Health and Disease


Early-life conditions and older adult health in low- and middle-income countries: a review

M. McEniry 

Institute for Social Research, ICPSR, Population Studies Center, University of Michigan, Ann Arbor, USA


Population aging and subsequent projected large increases in chronic conditions will be important health concerns in low- and middle-income countries. Although evidence is accumulating, little is known regarding the impact of poor early-life conditions on older adult (50 years and older) health in these settings. A systematic review of 1141 empirical studies was conducted to identify population-based and community studies in low- and middle-income countries, which examined associations between early-life conditions and older adult health. The resulting review of 20 studies revealed strong associations between (1) in utero/early infancy exposures (independent of other early life and adult conditions) and adult heart disease and diabetes; (2) poor nutrition during childhood and difficulties in adult cognition and diabetes; (3) specific childhood illnesses such as rheumatic fever and malaria and adult heart disease and mortality; (4) poor childhood health and adult functionality/disability and chronic diseases; (5) poor childhood socioeconomic status (SES) and adult mortality, functionality/disability and cognition; and (6) parental survival during childhood and adult functionality/disability and cognition. In several instances, associations remained strong even after controlling for adult SES and lifestyle. Although exact mechanisms cannot be identified, these studies reinforce to some extent the importance of early-life environment on health at older ages. Given the paucity of cohort data from the developing world to examine hypotheses of early-life conditions and older adult health, population-based studies are relevant in providing a broad perspective on the origins of adult health.

(Received December 12 2011)

(Revised May 25 2012)

(Accepted June 20 2012)

(Online publication July 20 2012)

Key words

  • adult health;
  • early-life conditions;
  • low- and middle-income countries;
  • population aging


Address for correspondence: Dr M. McEniry, Institute for Social Research, ICPSR, Population Studies Center, University of Michigan, 1106G Perry Building, 330 Packard, Ann Arbor, Michigan 48104, United States of America. (Email