童年不良经历和社会参与对中老年人衰弱状态转变的影响：来自中国一项为期 10 年的前瞻性研究的证据。

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging Pub Date : 2024-10-21 DOI:10.1016/j.jnha.2024.100400

Jiajia Li , Heming Pei , Xiaojin Yan , Yue Wei , Gong Chen , Lijun Pei

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引用次数: 0

摘要

目的：童年不良经历（ACEs）与虚弱有关，但与虚弱状态转变的关系以及社会参与的作用仍不清楚。本研究旨在探讨ACE与虚弱状态转换之间的关系，以及社会参与的调节作用。方法：本研究分析了中国健康与退休纵向研究（2011-2020年）中9621名45岁及以上成年人的数据。虚弱程度通过虚弱指数进行测量，而ACE和社会参与则通过有效问卷进行测量。采用多状态模型估计了ACE与虚弱状态转换之间的关系。结果显示，ACEs得分越高的参与者，其体质越弱，而ACEs得分越低的参与者，其体质越弱：结果：ACE评分越高（≥4分）的参与者向前过渡的概率越大（从强壮到虚弱前，HR=1.37，95%CI：1.21-1.54；从虚弱前到虚弱，HR=1.39，95%CI：1.18-1.63），向后过渡的概率越小（从虚弱前到强壮，HR=0.64，95%CI：0.55-0.76）。此外，中度和高度社会参与的参与者与后向转变的概率增加有关（从虚弱前到强壮，HR = 1.11，95%CI：1.01-1.23；从虚弱到虚弱前，HR = 1.17，95%CI：1.02-1.33）。社会参与调节了ACEs暴露与虚弱之间的关系（P为交互作用结论）：ACE得分高与身体虚弱不良发展的可能性增加有关。有ACE暴露的老年人可能会受益于改善社会参与的干预策略。

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Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in China

Objectives

Adverse childhood experiences (ACEs) are associated with frailty, while the association with frailty state transitions and the role of social participation remain unclear. This study aimed to investigate the association between ACEs and frailty state transitions, alongside the moderating effect of social participation

Methods

Data from 9,621 adults aged 45 and older from the China Health and Retirement Longitudinal Study (2011–2020) were analyzed. Frailty was measured with the frailty index, while ACEs and social participation were measured with a validated questionnaire. The association between ACEs and frailty state transitions was estimated using multi-state models. An interaction analysis were used to examine the moderating effects of social participation.

Results

Participants with higher ACEs scores (≥4) were associated with an increased probability of forward transition (robust to pre-frail, HR = 1.37, 95%CI: 1.21–1.54; prefrail to frail, HR = 1.39, 95%CI: 1.18–1.63) and decreased probability of backward transition (pre-frail to robust, HR = 0.64, 95%CI: 0.55–0.76). Additionally, participants with moderate and high level social participation were associated with an increased probability of backward transition (pre-frail to robust, HR = 1.11, 95%CI: 1.01–1.23; frail to pre-frail, HR = 1.17, 95%CI: 1.02–1.33, respectively). Social participation moderated the association between ACEs exposure and frailty (P for interaction <0.05), while participants with lower ACEs scores (1 and 2) and high social participation were associated with an increased probability of transition from frail to pre-frail (HR = 1.26, 95%CI: 1.04–1.89 and HR = 1.15, 95%CI: 1.08–1.69).

Conclusions

High ACEs scores were associated with an increased likelihood of adverse frailty development. Older adults with ACEs exposure might benefit from intervention strategies to improve social participation.

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来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.