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Adverse childhood experiences and the development of multimorbidity across adulthood-a national 70-year cohort study.
Chandrasekar, Rahul; Lacey, Rebecca E; Chaturvedi, Nishi; Hughes, Alun D; Patalay, Praveetha; Khanolkar, Amal R.
Afiliación
  • Chandrasekar R; University College London Medical School, London WC1E 6BT, UK.
  • Lacey RE; Research Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK.
  • Chaturvedi N; MRC Unit for Lifelong Health and Ageing at University College London, London WC1E 7HB, UK.
  • Hughes AD; MRC Unit for Lifelong Health and Ageing at University College London, London WC1E 7HB, UK.
  • Patalay P; MRC Unit for Lifelong Health and Ageing at University College London, London WC1E 7HB, UK.
  • Khanolkar AR; Centre for Longitudinal Studies, University College London Social Research Institute, London WC1H 0AL, UK.
Age Ageing ; 52(4)2023 04 01.
Article en En | MEDLINE | ID: mdl-37104379
AIM: To examine impact of adverse childhood experiences (ACE) on rates and development of multimorbidity across three decades in adulthood. METHODS: Sample: Participants from the 1946 National Survey of Health and Development, who attended the age 36 assessment in 1982 and follow-up assessments (ages 43, 53, 63, 69; N = 3,264, 51% males). Prospectively collected data on nine ACEs was grouped into (i) psychosocial, (ii) parental health and (iii) childhood health. For each group, we calculated cumulative ACE scores, categorised into 0, 1 and ≥2 ACEs. Multimorbidity was estimated as the total score of 18 health disorders.Serial cross-sectional linear regression was used to estimate associations between grouped ACEs and multimorbidity during follow-up. Longitudinal analysis of ACE-associated changes in multimorbidity trajectories across follow-up was estimated using linear mixed-effects modelling for ACE groups (adjusted for sex and childhood socioeconomic circumstances). FINDINGS: Accumulation of psychosocial and childhood health ACEs were associated with progressively higher multimorbidity scores throughout follow-up. For example, those with ≥2 psychosocial ACEs experienced 0.20(95% CI 0.07, 0.34) more disorders at age 36 than those with none, rising to 0.61(0.18, 1.04) disorders at age 69.All three grouped ACEs were associated with greater rates of accumulation and higher multimorbidity trajectories across adulthood. For example, individuals with ≥2 psychosocial ACEs developed 0.13(-0.09, 0.34) more disorders between ages 36 and 43, 0.29(0.06, 0.52) disorders between ages 53 and 63, and 0.30(0.09, 0.52) disorders between ages 63 and 69 compared with no psychosocial ACEs. INTERPRETATIONS: ACEs are associated with widening inequalities in multimorbidity development in adulthood and early old age. Public health policies should aim to reduce these disparities through individual and population-level interventions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Experiencias Adversas de la Infancia Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Age Ageing Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Experiencias Adversas de la Infancia Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Age Ageing Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido