Association of Adverse Childhood Experiences With Frailty Index Level and Trajectory in China.
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ABSTRACT:
SUBMITTER: Wang Q
PROVIDER: S-EPMC9344355 | biostudies-literature | 2022 Aug
REPOSITORIES: biostudies-literature
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Association of Adverse Childhood Experiences With Frailty Index Level and Trajectory in China.
JAMA network open 20220801 8
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Project description:Cross-national differences in the health implication of adverse childhood experiences have been documented. The differences may be shaped by macro- and micro-social context. However, previous studies failed to consider the role of micro-level social contexts, where adverse childhood experiences happen, in affecting the cross-national differences. The study aims to estimate the association between adverse childhood experiences and Frailty Index across countries and micro-social contexts, and then reveal how cross-national difference in the association between adverse childhood experiences and Frailty Index were shaped by social contexts. Adulthood information were collected from three waves of the Survey of Health, Ageing and Retirement in Europe in 2010, 2013, and 2015, and the China Health and Retirement Longitudinal Study data from in 2013, 2015 and 2018, respectively. Frailty index was measured based on 35 health measurements. Eleven adversities, including intrafamilial aggression and neglect, family dynamics, and socioeconomic status etc, were extracted from the life history survey of the two datasets, conducted in 2017 and 2014, respectively. Weighted Linear regression models and the smoothing-differencing method were applied. Experiencing three or more adversities was associated with increase in frailty index level in Europe and China. The effect size ranged from 0.015 (95%CI: 0.011-0.019) in China to 0.030 (95%CI: 0.025-0.034) in Germanic countries. Poor parent-child relationship, parental absence/death were ACEs in terms of frail in European countries but not in China. In a context where adversities were moderately likely to happen, the association between experiencing adverse childhood experiences and Frailty Index were greatest. Cross-national differences of adverse childhood experiences effects were most derived from this social context. These findings highlight the importance of micro-social contexts while mitigating early life stress to promote life-course health. Individuals who were moderately likely to experience adversity should be paid special attention in terms of health implication of adverse childhood experiences.
| S-EPMC10148028 | biostudies-literature
Project description:An association between adverse childhood experiences (ACEs) and elevated body mass index (BMI) has been found in previous investigations. ACEs' effects on BMI have been primarily considered via individual-level physiological and behavioral frameworks. Neighborhood factors, such as greenspace, are also associated with BMI and may merit consideration in studies examining ACEs-BMI associations. This exploratory study examined associations of BMI with ACEs and neighborhood greenspace and tested whether greenspace moderated ACEs-BMI associations. Methods entailed secondary analysis of cross-sectional data. ACEs and BMI were captured from 2012/2013 Philadelphia ACE Survey and 2012 Southeastern Household Heath Survey data; greenspace percentage in participants' (n = 1,679 adults) home neighborhoods was calculated using National Land Cover Database data. Multi-level, multivariable linear regression 1) examined associations between BMI, ACEs, (0 ACEs [reference], 1-3 ACEs, 4 + ACEs), and neighborhood greenspace levels (high [reference], medium, low) and 2) tested whether greenspace moderated the ACEs-BMI association (assessed via additive interaction) before and after controlling for sociodemographic and health-related covariates. Experiencing 4 + ACEs (β = 1.21; 95 %CI: 0.26, 2.15; p = 0.01), low neighborhood greenspace (β = 1.51; 95 %CI: 0.67, 2.35; p < 0.01), and medium neighborhood greenspace (β = 1.37; 95 %CI: 0.52, 2.21; p < 0.01) were associated with BMI in unadjusted models. Only low neighborhood greenspace was associated with BMI (β = 0.95; 95 %CI: 0.14, 1.75; p = 0.02) in covariate-adjusted models. The ACEs-greenspace interaction was not significant in unadjusted (p = 0.89-0.99) or covariate-adjusted (p = 0.46-0.79) models. In conclusion, when considered simultaneously, low neighborhood greenspace, but not ACEs, was associated with BMI among urban-dwelling adults in covariate-adjusted models.
| S-EPMC9326311 | biostudies-literature
Project description:Background Exposure to adverse childhood experiences (ACEs) is associated with many childhood diseases and poor health outcomes in adulthood. However, the association with childhood obesity is inconsistent. We investigated the association between reported cumulative ACE score and body mass index (BMI) in a large sample of patients at a single institution. Methods This cross-sectional study included children aged 2–20 years that were screened in a general pediatrics clinic for ACEs utilizing the Center for Youth Wellness ACEs questionnaire between July 2017 and July 2018. Overall ACE score was categorized as ‘no exposure’ (score = 0), ‘low exposure’ (score = 1), and ‘high exposure’ (score? 2). BMI was categorized as overweight/obese (BMI percentile ? 85) or non-obese (BMI percentile < 85). The association between ACEs score and obesity was determined using univariate and multivariable logistic regression. Results Of the 948 patients included in the study, 30% (n = 314) were overweight/obese and 53% (n = 504) had no ACE exposure, 19% (n = 179) had low ACE exposure, and 28% (n = 265) had high ACE exposure. High ACE exposure was associated with increased odds of obesity (OR = 1.47, 95%CI = 1.07–2.03, p = 0.026). However, after adjusting for age, race/ethnicity, insurance type, and birth weight, the association attenuated and was null (OR = 1.01, 95%CI = 0.70–1.46, p = 0.97). Conclusion The study findings may suggest an association between ACE and childhood obesity. However, the association attenuated after adjusting for age, race/ethnicity, insurance type, and birth weight. Larger prospective studies are warranted to better understand the association.
| S-EPMC7523986 | biostudies-literature
Project description:ObjectiveEarly adverse childhood experiences (ACEs) have been linked to the development of both internalizing and externalizing psychopathology. In our prior work, we found that ACEs predicted reductions in the volume of the inferior frontal gyrus (IFG), a brain region important for impulse control and emotion regulation. Here we tested the hypothesis that ACEs might influence child behavioral outcomes through an impact on IFG functional connectivity, which may influence impulsive or risk-taking behavior.MethodWe examined the effects of prospectively assessed ACEs on IFG connectivity in childhood, and their relationship to the trajectory of subsequent psychopathology from late school age and early adolescence, using data from an 11-year longitudinal study of children starting in preschool that included 3 waves of resting state functional connectivity across childhood and early adolescence.ResultsACEs predicted functional connectivity of both left and right IFG. Multi-level modeling of symptoms across 3 waves of assessments indicated that more ACEs predicted both internalizing and externalizing symptoms. However, altered IFG connectivity specifically predicted greater externalizing symptoms over time in middle childhood and early adolescence, as compared to internalizing symptoms. Longitudinal modeling indicating that the relationships between externalizing and functional connectivity were maintained across 3 waves of functional connectivity assessment.ConclusionThese findings underscore the relationship of ACEs to later psychopathology, and suggest that connectivity of the IFG, a region known to play an important role in impulse control and emotion regulation, may play a key role in the risk trajectory of ACEs to externalizing problems. However, further work is needed to understand whether these relationships reflect a direct effect of ACEs or whether ACEs are a marker for other environmental or genetic factors that may also influence brain development and behavior.
| S-EPMC5836492 | biostudies-literature
Project description:ObjectiveAdverse childhood experiences (ACEs) are linked to worsening overall health outcomes and psychological diagnoses. Routine screening, particularly in patients with postpartum depression (PPD), would identify patients who could benefit from interventions to prevent the perpetuation of ACEs and establish a system of preventative care to mitigate the risks of adverse health outcomes associated with high ACE scores. The purpose of this study is to explore the link between ACEs and PPD to advocate for the use of the ACE questionnaire as a routine screening tool in all pregnant patients diagnosed with PPD. We hypothesize that a cohort of patients with PPD will be more likely to have high-risk ACE scores than the general female population.Study designOur IRB approved, retrospective cohort study identified all patients diagnosed with PPD at an academic medical center between January 2015 and December 2019. The subjects were identified using retrospective chart review. Subjects were recruited via telephone and asked to complete an ACE questionnaire. Questionnaires were sent via RedCap. ACE scores were calculated, categorized as 0, 1, 2, 3, or 4 or more ACEs, and compared to the prevalence in the original Kaiser-CDC ACE study female cohort using a chi-square goodness-of-fit test.ResultsThere were 132/251 surveys completed (53% response rate). In our PPD population, 19.3% had 0 ACEs, 17.0% had 1 ACE, 13.1% had 2 ACEs, 16.5% had 3 ACEs, and 34.1% had 4 or more ACEs. These percentages were significantly different from the Kaiser-CDC ACE Study percentages of 34.5, 24.5, 15.5, 10.3, and 15.2%, respectively (p < 0.001).ConclusionOur unique study showed that women with PPD are more likely to have high-risk ACE scores than the general female population. This finding has important implications in regards to counseling, intervening to prevent perpetual ACEs, and establishing important provider-patient relationships for life-long preventative care.Non-gendered language is used when possible throughout. However, the wording from studies cited in this paper was preserved.
| S-EPMC9183059 | biostudies-literature
Project description:Adverse childhood experiences (ACEs) are associated with numerous physical and mental health issues in children and adults. The effect of ACEs on development of childhood obesity is less understood. This systematic review was undertaken to synthesize the quantitative research examining the relationship between ACEs and childhood obesity. PubMed, PsycInfo, and Web of Science were searched in July 2020; Rayyan was used to screen studies, and the Newcastle-Ottawa Scale was used to assess risk of bias. The search resulted in 6,966 studies screened at title/abstract and 168 at full-text level. Twenty-four studies met inclusion criteria. Study quality was moderate, with greatest risk of bias due to method of assessment of ACEs or sample attrition. Findings suggest ACEs are associated with childhood obesity. Girls may be more sensitive to obesity-related effects of ACEs than boys, sexual abuse appears to have a greater effect on childhood obesity than other ACEs, and co-occurrence of multiple ACEs may be associated with greater childhood obesity risk. Further, the effect of ACEs on development of childhood obesity may take 2-5 years to manifest. Considered collectively, findings suggest a need for greater attention to ACEs in the prevention and treatment of childhood obesity.
| S-EPMC8192341 | biostudies-literature
Project description:ImportancePast studies have showed associations between antibiotic exposure and child weight outcomes. Few, however, have documented alterations to body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) trajectory milestone patterns during childhood after early-life antibiotic exposure.ObjectiveTo examine the association of antibiotic use during the first 48 months of life with BMI trajectory milestones during childhood in a large cohort of children.Design, setting, and participantsThis retrospective cohort study used electronic health record data from 26 institutions participating in the National Patient-Centered Clinical Research Network from January 1, 2009, to December 31, 2016. Participant inclusion required at least 1 valid set of same-day height and weight measurements at each of the following age periods: 0 to 5, 6 to 11, 12 to 23, 24 to 59, and 60 to 131 months (183 444 children). Data were analyzed from June 1, 2019, to June 30, 2020.ExposuresAntibiotic use at 0 to 5, 6 to 11, 12 to 23, 24 to 35, and 36 to 47 months of age.Main outcomes and measuresAge and magnitude of BMI peak and BMI rebound.ResultsOf 183 444 children in the study (mean age, 3.3 years [range, 0-10.9 years]; 95 228 [51.9%] were boys; 80 043 [43.6%] were White individuals), 78.1% received any antibiotic, 51.0% had at least 1 episode of broad-spectrum antibiotic exposure, and 65.0% had at least 1 episode of narrow-spectrum antibiotic exposure at any time before 48 months of age. Exposure to any antibiotics at 0 to 5 months of age (vs no exposure) was associated with later age (β coefficient, 0.05 months [95% CI, 0.02-0.08 months]) and higher BMI (β coefficient, 0.09 [95% CI, 0.07-0.11]) at peak. Exposure to any antibiotics at 0 to 47 months of age (vs no exposure) was associated with an earlier age (-0.60 months [95% CI, -0.81 to -0.39 months]) and higher BMI at rebound (β coefficient, 0.02 [95% CI, 0.01-0.03]). These associations were strongest for children with at least 4 episodes of antibiotic exposure. Effect estimates for associations with age at BMI rebound were larger for those exposed to antibiotics at 24 to 35 months of age (β coefficient, -0.63 [95% CI, -0.83 to -0.43] months) or 36 to 47 (β coefficient, -0.52 [95% CI, -0.72 to -0.31] months) than for those exposed at 0 to 5 months of age (β coefficient, 0.26 [95% CI, 0.01-0.51] months) or 6 to 11 (β coefficient, 0.00 [95% CI, -0.20 to 0.20] months).Conclusions and relevanceIn this cohort study, antibiotic exposure was associated with statistically significant, but small, differences in BMI trajectory milestones in infancy and early childhood. The small risk of an altered BMI trajectory milestone pattern associated with early-life antibiotic exposure is unlikely to be a key factor during prescription decisions for children.
| S-EPMC8276083 | biostudies-literature
Project description:ImportanceStudies investigating the association of threat-related and deprivation-related adverse childhood experiences (ACEs) with later-life cognitive decline are lacking.ObjectivesTo evaluate the independent association of threat-related and deprivation-related ACEs with cognitive decline over time among middle-aged and older Chinese adults and to examine the modifying role of social isolation in such associations.Design, setting, and participantsThis prospective cohort study used cognitive data from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey that was administered between June 1, 2011, and March 31, 2012, and the CHARLS follow-up survey administered between July 1 and September 30, 2015. The life history survey with information of ACEs was additionally administered between June 1 and December 31, 2014. Statistical analysis was performed from March 1 to July 31, 2022. The study population consisted of middle-aged and older adults (age range, 45-97 years) with complete data on ACEs and 2 cognitive assessments and without cognitive impairment at baseline.ExposuresFive threat-related ACEs (ie, physical abuse, household substance abuse, domestic violence, unsafe neighborhood, and bullying) and 5 deprivation-related ACEs (ie, emotional neglect, household mental illness, incarcerated household member, parental separation or divorce, and parental death) before 17 years of age were queried by questionnaires. The cumulative scores of the 2 ACE dimensions were calculated and grouped into 3 categories as 0, 1, and 2 or more in main analyses.Main outcomes and measuresCognitive function was measured by episodic memory and executive function. Global cognition was further calculated as the total score of these 2 dimensions. The raw scores of each cognitive test were standardized to z scores using baseline means and SDs. Linear mixed-effects models were constructed to examine the association between 2 dimensions of ACEs and the rate of annual cognitive decline. The modifying role of baseline social isolation in such associations was assessed with 3-way interaction tests.ResultsOf the 6466 participants included in main analyses, 3301 (51.1%) were men and the mean (SD) age was 57.2 (8.3) years. Compared with no exposures, experience of 1 deprivation-related ACE was associated with faster cognitive decline in global cognition (β = -0.012 [95% CI, -0.022 to -0.002] SD/y) and executive function (β = -0.010 [95% CI, -0.020 to -0.00002] SD/y), whereas individuals with at least 2 childhood deprivations had faster cognitive declines in all cognitive tests (β = -0.035 [95% CI, -0.050 to -0.019] SD/y for global cognition; β = -0.047 [95% CI, -0.068 to -0.025] SD/y for episodic memory; β = -0.019 [95% CI, -0.034 to -0.004] SD/y for executive function). However, such an association was not observed for threat-related ACEs. In addition, baseline social isolation was a significant modifier in the associations between deprivation-related ACEs and cognitive declines in global cognition (β = -0.033 [95% CI, -0.061 to -0.005] SD/y; P = .02 for 3-way interaction) and executive function (β = -0.032 [95% CI, -0.059 to -0.005] SD/y; P = .02 for 3-way interaction).Conclusions and relevanceDeprivation-related ACEs, but not threat-related ACEs, were associated with faster decline in later-life cognitive function, whereas social isolation could modify such detrimental impact. These findings highlight the potential benefits of promoting social integration in maintaining later-life cognitive function among individuals who have experienced childhood deprivation.
| S-EPMC9652754 | biostudies-literature
Project description:Events causing stress responses during sensitive periods of rapid neurological development in childhood may be early determinants of all-cause premature mortality. Using a British birth cohort study of individuals born in 1958, the relationship between adverse childhood experiences (ACE) and mortality?50 year was examined for men (n=7,816) and women (n=7,405) separately. ACE were measured using prospectively collected reports from parents and the school: no adversities (70%); one adversity (22%), two or more adversities (8%). A Cox regression model was carried out controlling for early life variables and for characteristics at 23 years. In men the risk of death was 57% higher among those who had experienced 2+ ACE compared to those with none (HR 1.57, 95% CI 1.13, 2.18, p=0.007). In women, a graded relationship was observed between ACE and mortality, the risk increasing as ACE accumulated. Women with one ACE had a 66% increased risk of death (HR 1.66, 95% CI 1.19, 2.33, p=0.003) and those with ?2 ACE had an 80% increased risk (HR 1.80, 95% CI 1.10, 2.95, p=0.020) versus those with no ACE. Given the small impact of adult life style factors on the association between ACE and premature mortality, biological embedding during sensitive periods in early development is a plausible explanatory mechanism.
| S-EPMC3787798 | biostudies-other
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