Adverse Childhood Experiences and Subsequent Chronic Diseases Among Middle-aged or Older Adults in China and Associations With Demographic and Socioeconomic Characteristics.
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ABSTRACT:
SUBMITTER: Lin L
PROVIDER: S-EPMC8546496 | biostudies-literature | 2021 Oct
REPOSITORIES: biostudies-literature
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Adverse Childhood Experiences and Subsequent Chronic Diseases Among Middle-aged or Older Adults in China and Associations With Demographic and Socioeconomic Characteristics.
Lin Li L Wang Harry Haoxiang HH Lu Ciyong C Chen Weiqing W Guo Vivian Yawei VY
JAMA network open 20211001 10
<h4>Importance</h4>Associations between adverse childhood experiences (ACEs) and chronic diseases among middle-aged or older Chinese individuals have not been well documented. In addition, whether demographic and socioeconomic characteristics modify any such associations has been underexplored.<h4>Objectives</h4>To examine associations between ACEs and subsequent chronic diseases and to assess whether age, sex, educational level, annual per capita household expenditure level, and childhood econo ...[more]
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Project description:ObjectivesThis study examined the associations between adverse childhood experiences (ACEs) and diabetes within a social-ecological framework, incorporating personal and environmental unfavorable conditions during childhood from family, school, and community contexts.MethodsData were obtained from the China Health and Retirement Longitudinal Study (2014 life history survey and 2015 survey), including 9,179 participants aged ≥45 years. ACEs were collected through self-report questionnaires, and participants were categorized based on the number of distinct ACEs experienced (0, 1, 2, 3, or ≥4 ACEs). Diabetes was defined by biomarkers, self-reported diagnosis, and treatment status. Logistic regression was conducted to explore the associations between ACEs and diabetes. Subgroup analyses were conducted by gender, age, and obesity status.ResultsCompared with participants without ACEs, those exposed to any ACE (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.01 to 1.40), 3 ACEs (OR, 1.32; 95% CI, 1.07 to 1.62) and ≥4 ACEs (OR, 1.29; 95% CI, 1.07 to 1.56) had an increased risk of diabetes. For each additional ACE, the risk of diabetes increased by about 5%. Regarding the source of ACEs, those originating from the family (OR, 1.23; 95% CI, 1.08 to 1.41) were associated with diabetes. In terms of specific ACE types, family members with substance abuse (OR, 1.23; 95% CI, 1.01 to 1.52), emotional abuse (OR, 1.28; 95% CI, 1.12 to 1.46), and poor parental relationship (OR, 1.25; 95% CI, 1.09 to 1.43) were associated with diabetes.ConclusionsACEs, particularly those originating from the family, were associated with diabetes. Interventions aimed at preventing and mitigating ACEs are essential for the early prevention of diabetes.
| S-EPMC10728618 | biostudies-literature
Project description:BackgroundAdverse Childhood Experiences (ACEs) have been implicated in the development of body pain, yet research on their impact on body pain and its progression remains scarce. This study aimed to examine the associations between ACEs and the presence and areas of body pain, as well as their developmental trajectories among middle-aged and older Chinese adults.MethodsWe included participants aged 45 years and above from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2018. Retrospective data on ACEs and pain sites were collected with questionnaires. The presence of pain at different body sites was categorized into three areas: head & neck, trunk, and limbs. ACEs consisted of ten types of adverse experiences and were cumulatively scored. For the cross-sectional analysis (2011), logistic regressions were performed to estimate the associations between ACEs and pain presence in specific areas. In the longitudinal analysis (2011-2018), we further applied group-based trajectory modelling (GBTM) to determine the developmental trajectories of body pain. Multinomial logistic regressions were then conducted to estimate the associations between ACEs and pain trajectories.ResultsIn the cross-sectional analysis (n = 8157), ACEs were positively associated with the presence of pain in the head & neck (odds ratio [OR] = 3.55, 95% confidence intervals [CI] = 2.37-4.74), trunk (OR = 3.28, 95% CI = 2.47-4.34), and limbs areas (OR = 2.30, 95% CI = 1.77-3.00) compared to no ACEs. These associations varied by sex and residence. In the longitudinal analysis (n = 5188), GBTM identified three developmental trajectories of body pain (n = 9521): high-increasing (7.44%), low-moderate (33.67%) and maintained-low trajectories (58.89%) trajectories. Compared to participants without ACEs, individuals had three ACEs and 4 or more ACEs were consistently associated with low-moderate (three ACEs: OR = 2.26, 95% CI = 1.81-2.83, four or more ACEs: OR = 3.11, 95% CI = 2.51-3.87) and high-increasing (three ACEs: OR = 3.28, 95% CI = 2.03-5.30, four or more ACEs: OR = 6.78, 95% CI = 4.30-10.68) body pain trajectories across sexes and residence.ConclusionThis study highlighted the significant association between ACEs and body pain among middle-aged and older Chinese, emphasizing the importance of preventing or mitigating ACEs as a strategy for the prevention and management of body pain.
| S-EPMC11562079 | biostudies-literature
Project description:Adverse childhood experiences (ACEs) among middle-aged and elderly individuals may influence the subsequent occurrence of chronic kidney disease (CKD). We aim to investigate the association between ACEs and CKD among the middle-aged and elderly populations in China. The prospective cohort longitudinal study examined baseline data from the China Health and Retirement Longitudinal Study (CHARLS) from June 1 to December 31, 2014. Subsequent follow-up surveys were conducted in 2015, 2018, and 2020. The study population consisted of 4063 participants aged at least 45 years, who had CKD data and information on the 16 complete ACEs indicators included in this study. Utilizing correlation analysis to explore the relationship between CKD and the total score of ACEs, as well as the three dimensions (Conventional ACEs, Expanded ACEs, and New ACEs), along with specific items. The correlation between individual ACEs, disease-related factors, and CKD was examined using binary logistic regression models. Valuable diagnostic factors were then identified through the use of ROC curves. A Cox proportional hazards regression model, with age as the timescale and ACEs groups as covariates, was established to investigate the relationship between age-related CKD occurrence and ACE groups as individuals aged. Among the 4063 participants included in the analysis, in patients with CKD, the male proportion is 85 (64.9%), and the female proportion is 46 (35.1%). Of the participants, 2332 experienced at least two Conventional ACEs, 3786 experienced at least two Expanded ACEs, and 2774 experienced at least one New ACE. Factors influencing the occurrence of CKD in participants included Conventional ACEs 5 (OR 1.742; 95% CI 1.115-2.721; P = 0.015), Conventional ACEs 6 (OR 1.581; 95% CI 1.024-2.442; P = 0.039), Conventional ACEs 9 (OR 2.190; 95% CI 1.288-3.725; P = 0.004), Expanded ACEs 3 (OR 0.195; 95% CI 0.085-0.444; P < 0.001), memory-related disease (OR 3.297; 95% CI 1.140-9.538; P = 0.028), dyslipidemia (OR 2.536; 95% CI 1.521-4.230; P < 0.001), cancer (OR 6.369; 95% CI 2.464-16.461; P < 0.001), chronic lung disease (OR 2.261; 95% CI 1.091-4.684; P = 0.028), and liver disease (OR 3.050; 95% CI 1.432-6.497; P = 0.004). These three models showed significant statistical differences in CKD, the Conventional ACEs, and the New ACEs. In Model 1, 2, and 3, the risk was higher for individuals exposed to the Conventional ACEs group, indicating an increased likelihood of developing CKD, the risk was lower for individuals exposed to the New ACEs group, suggesting a reduced likelihood of developing CKD. ROC curve analysis of these variables showed that CA5, CA6, CA9, dyslipidemia had significant diagnostic value for the occurrence of CKD. The accuracy of diagnosis was CA5 (57.0%), CA6 (58.3%), CA9 (59.4%), and dyslipidemia (59.8%). This study, through longitudinal investigation, has identified potential links between ACEs and disease-related factors with CKD. These findings can still provide assistance to clinicians and public health administrators, helping them understand the association between ACEs and CKD, and offering theoretical support for their clinical decision-making or development of public health policies.
| S-EPMC11847003 | biostudies-literature
Project description:BackgroundAdverse childhood experiences (ACEs), low socioeconomic status (SES), and harsh parenting practices each represent well-established risk factors for mental health problems. However, research supporting these links has often focused on only one of these predictors and psychopathology, and interactions among these variables in association with symptoms are not well understood.ObjectiveThe current study utilized a cross-sectional, multi-informant, and multi-method design to investigate the associations of ACEs, SES, parenting, and concurrent internalizing and externalizing problems in adolescents.Participants and settingData are from a volunteer sample of 97 adolescents and their caregivers recruited from 2018 to 2021 in a southern U.S. metropolitan area to sample a range of exposure to ACEs.MethodsMultiple linear regression models were used to assess associations among adolescents' ACEs exposure, SES, observed parenting practices, and symptoms of internalizing and externalizing psychopathology.ResultsLower SES was associated with higher levels of internalizing and externalizing symptoms, while higher ACEs exposure and observed parenting were related to externalizing but not internalizing symptoms. Associations of adolescents' exposure to physical abuse and perceived financial insecurity with externalizing symptoms were moderated by warm and supportive parenting behaviors. Conversely, harsh parenting was linked to increased levels of externalizing symptoms, particularly in the context of low income.ConclusionsFindings suggest that the presence of multiple risk factors may incur greater vulnerability to externalizing problems, while warm and supportive parenting practices may provide a buffer against externalizing problems for adolescents exposed to physical abuse. Links between ACEs, SES, parenting, and youth adjustment should continue to be explored, highlighting parenting as a potentially important and malleable intervention target.
| S-EPMC8826588 | biostudies-literature
Project description:Background: The association between adverse childhood experiences (ACEs) and obesity in developing countries has been underexplored and inconsistent. Methods: This cross-sectional study used data of 10,054 adults aged ≥ 45 years from the China Health and Retirement Longitudinal Study. Information on 12 ACE indicators was collected via questionnaires. General obesity was defined as a body mass index (BMI) of ≥28 kg/m². Central obesity was defined as a waist circumference of ≥90 cm for males and ≥85 cm for females. Logistic and linear regression analyses were conducted to evaluate the association of ACEs with general obesity, central obesity, BMI, and waist circumference where appropriate. Results: Compared to the non-exposed group, the experience of ≥3 ACEs was significantly associated with decreased risks of general obesity (OR = 0.83, 95% CI: 0.69, 0.999), central obesity (OR = 0.88, 95% 0.77, 0.997), and smaller BMI (β = −0.27, 95% CI: −0.50, −0.04) and waist circumference (β = −0.89, 95% CI: −1.52, −0.26). Compared to the high socioeconomic status (SES) group, such associations were more evident in those with a low SES, except for central obesity. Conclusion: ACEs were shown to be inversely associated with later-life obesity in China, especially in socioeconomically disadvantaged populations. The context-specific impacts reflect divergent roles of socioeconomic position in the obesity epidemic between developed and developing countries. Further investigations are needed to confirm whether physical activity could shift the direction of this association.
| S-EPMC9180433 | biostudies-literature
Project description:ObjectiveAdverse childhood experiences (ACEs) have been associated with a range of adverse health outcomes, with pain being potentially one of them. This population-based cross-sectional study aimed to investigate the associations between Adverse Childhood Experiences (ACEs) and pain in Chinese adults and evaluate whether physical activity and demographic and socioeconomic characteristics modify this associations.MethodsCross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS), were utilized in this study. A total of 9923 respondents with information on 12 ACE indicators and 15 self-reported body pains were included. Logistic regression models were used to assess associations of the ACEs and pain. Modification of the associations by physical activity, demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction.ResultsAmong the 9923 individuals included in the primary analyses, 5098 (51.4%) males and the mean (SD) age was 61.18 (10·.44) years. Compared with individuals with 0 ACEs, those who with ≥ 5 ACEs had increased risk of single pains and multiple pain. A dose-response association was found between the number of ACEs and the risk of pain (e.g. neck pain for ≥ 5 ACEs vs. none: OR, 1.107; 95% CI, 0.903-1.356; p < 0.001 for trend). In the associations of each body pain with each ACE indicator, most ACE indicators were associated with an increased risk of pain. In addition, physical activity, sociodemographic and socioeconomic characteristics, such as age, sex, educational level, area of residence, childhood economic hardship, did not demonstrate a significant modify on the associations between ACEs and pain.ConclusionsThese findings indicate that cumulative ACE exposure is associated with increased odds of self-reported pain in Chinese adults, regardless of adult physical activity, sociodemographic and socioeconomic characteristics.
| S-EPMC11218369 | biostudies-literature
Project description:BackgroundEvidence on the association between adverse childhood experiences (ACEs) and handgrip strength (HGS) in later life was limited and inconclusive. We aimed to explore the impact of ACEs on HGS among middle-aged and older Chinese adults.MethodsWe conducted a cross-sectional study with data extracted from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey with respondents recruited from 450 villages/urban communities of 28 provinces. Participants aged 45 years or older were drawn from the CHARLS 2014 life history survey and the 2015 health survey. Twelve ACE indicators before the age of 17 years were collected. HGS was measured with a dynamometer and the maximum value of HGS obtained from both hands was used in the analyses. Low muscle strength (LMS) was defined according to the recommendation of European Working Group on Sarcopenia in Older People (EWGSOP). Multivariate linear and logistic regression models were constructed to evaluate the association of ACEs with continuous HGS and LMS, with adjustment for age, sex, marital status, ethnicity, area of residence, smoking and drinking status, body mass index, hypertension, dyslipidaemia, diabetes mellitus, cardiovascular disease, arthritis, hip fracture, and memory-related disease.ResultsOf the 7209 eligible participants, 2258 (31.3%) had experienced three or more ACEs. Compared to individuals without ACEs, exposure to ≥ 3 ACEs was negatively associated with continuous HGS in kilogram (β = -0.93, 95% CI: -1.37, -0.49) and positively associated with the risk of LMS (OR = 1.34, 95% CI: 1.12, 1.61). Such associations were consistently found both in men and women who had experienced three or more ACEs. Significant dose-response relationship between the number of ACEs and outcomes was also observed in the overall population and different sex groups.ConclusionExposure to ACEs was associated with lower HGS and increased risk of LMS among middle-aged and older Chinese adults, indicating the importance of intervention in individuals with experience of ACEs in order to mitigate its detrimental impact on HGS and promote healthy ageing.
| S-EPMC8840034 | biostudies-literature
Project description:More than 60 percent of US adults report that they had adverse childhood experiences (ACEs). For this study of 930,000 children born during the period 1999-2003, we used linked administrative, survey, and criminal justice data to measure the association between ACEs (parental death; separation; incarceration; or criminal charge for intimate partner violence, substance use disorder, or child sexual or nonsexual abuse) and socioeconomic disadvantages at ages 18-22 during 2017-21. After childhood socioeconomic status was controlled for, young adults with ACEs were more likely to have been charged with felonies, have become teenage parents, live in a household with poverty or housing assistance, be enrolled in Medicaid, and be employed, and were less likely to be enrolled in an educational institution. These outcomes were most likely among young adults with multiple ACEs or lower childhood socioeconomic status. Using new linked data opportunities, this study provides large-scale, person-level longitudinal evidence of the long-lasting and substantial societal cost of ACEs.
| S-EPMC11752160 | biostudies-literature
Project description:SignificanceThe findings to date indicate that adverse childhood experiences (ACEs) increase the risk of cardiovascular disease (CVD) in later life. We demonstrate how network analysis, a statistical method that estimates complex patterns of associations between variables, can be used to model ACEs and CVD. The main goal is to explore the differential impacts of ACE components on CVD outcomes, conditioned on other ACEs and important covariates using network analysis. We also sought to determine which ACEs are most synergistically correlated and subsequently cluster together to affect CVD risk.MethodsOur analysis was based on cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System, which included 31,242 adults aged 55 or older (54.6% women, 79.8% whites, mean age of 68.7 ± 7.85 years). CVD outcomes included angina/coronary heart disease (CHD) and stroke prevalence. Mixed graphical models were estimated using the R-package mgm, including all variables simultaneously to elucidate their one-to-one inter-relationships. Next, we conducted Walktrap cluster detection on the estimated networks using the R-package igraph. All analyses were stratified by gender to examine group differences.ResultsIn the network for men, the variable "household incarceration" was most strongly associated with stroke. For women, the strongest connection was between "physical abuse" and stroke, followed by "sexual abuse" and angina/CHD. For men, angina/CHD and stroke were clustered with several CVD risk factors, including depressive disorder, diabetes, obesity, physical activity, and smoking, and further clustered with components of household dysfunction (household substance abuse, household incarceration, and parental separation/divorce). No clusters emerged for women.ConclusionsSpecific ACEs associated with CVDs across gender may be focal points for targeted interventions. Additionally, findings from the clustering method (especially for men) may provide researchers with valuable information on potential mechanisms linking ACEs with cardiovascular health, in which household dysfunction plays a critical role.
| S-EPMC9947418 | biostudies-literature
Project description:BackgroundAdverse childhood experiences (ACE) have been associated with poor later life health outcomes, including cardiovascular disease (CVD). Limited research investigating potential underlying biological mechanisms linking ACE to CVD exists, particularly regarding lipid biomarkers.ObjectivesThe aim of this study was to examine the associations between childhood adversity and unfavourable lipid profiles and derived atherogenic risk indices in a middle-to-older aged population.MethodsThis cross-sectional study includes 1820 participants from the Mitchelstown cohort (49% male) in Ireland. Participants' self-reported history of childhood adversity (overall and by subtypes household dysfunction, abuse and neglect) were assessed through a validated 10-item ACE questionnaire. Lipid profiles were determined and atherogenic risk indices including Castelli's Risk Index 1 and 2 (CRI-I and CRI-II), Atherogenic Coefficient (AC) and Atherogenic Index Plasma (AIP) were generated. Logistic regression analysed ACE associations with unfavourable lipid outcomes, controlling for potential confounders.ResultsACE history (reported by 23% of sample), in particular childhood exposure to household dysfunction, was associated with later-life non-optimal TG and HDL-C concentrations and atherogenic risk indices CRI-II and AC in age and sex-adjusted models (all p < 0.05). In fully adjusted models, adults reporting ACE or exposure to household dysfunction were approximately twice as likely to have pro-atherogenic CRI-II relative to adults with no ACE (OR = 1.86, 95% CI: 1.19-2.92, p = 0.006 and OR = 2.19, 95% CI: 1.33-3.61, p = 0.002, respectively). Sex-stratified analysis demonstrated sex-specific associations.ConclusionsThis study provides evidence that ACEs are common among older adults in Ireland and are associated with unfavourable lipid profiles and derived atherogenic risk indices.
| S-EPMC10119964 | biostudies-literature