Association Between Adverse Childhood Experiences and Intrinsic Capacity Trajectories Among Older People in China: Evidence From CHARLS.

Abstract

ObjectiveThis study explored the effects of adverse childhood experiences (ACEs) in older adults on long-term intrinsic capacity (IC) and trajectories of change in IC over 5 years from 2011 to 2015.MethodsA total of 2847 participants aged 60 years and older from the China Health and Retirement Longitudinal Study (CHARLS) were included in analyses. Twelve ACEs were retrospectively assessed by questionnaire in 2014. The number of ACEs was summed and categorized into 5 groups: 0, 1, 2, 3, and 4 or more ACEs. IC was assessed using a measure that examined five domains: locomotor, cognitive, sensory, vitality, and psychological.ResultsOverall, 87.4% of participants reported exposure to at least 1 of the 12 ACEs (Group 2) and 16.6% had experienced 4 or more ACEs (Group 5). Compared to participants without ACEs exposure (Group 1), those experiencing 1, 2, 3 and 4 or more ACEs (Groups 2-5) predicted worse IC (β = 0.085, 95% CI = -0.169 to -0.001, P < 0.05, to β = -0.44, 95 % CI = -0.54 to -0.34, P < 0.001, respectively across the four groups, demonstrating a dose-effect response. Three IC trajectories were identified (low-stable, moderate-stable, and high stable). Individuals with experience 2, 3 and 4 or more ACEs (Groups 3-5) predicted a significantly increased risk of moderate-stable and low-stable IC trajectories. In addition, physical abuse, household mental illness, domestic violence, bullying and parental disability was negatively related to IC and predicted an increased risk of moderate-stable and low-stable trajectory in long-term follow-up.ConclusionExposure to ACEs negatively impacts IC and predicts increased risk of moderate-stable and low-stable IC trajectory (vs. high stable) over time.