{"title":"不良童年经历导致中老年健康风险增加：日常生活活动与慢性病的纵向中介效应","authors":"Yijun Liu, Zhe Zhao, Shiyin Tian, Shaojie Yu, Juanfang Zhu, Yuanyuan Yang, Qinqin Jiang, Jinhai Sun, Shengjun Wang, Lei Yuan","doi":"10.1016/j.inpsyc.2025.100117","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Adverse Childhood Experiences (ACEs) have long-term effects on health, but the mechanisms remain unclear.</p><p><strong>Objective: </strong>To investigate the association between ACEs and health status, exploring the potential mediating roles of activities of daily living (ADL) and chronic diseases.</p><p><strong>Participants and setting: </strong>9575 middle-aged and older adults from the China Health and Retirement Longitudinal Study (CHARLS).</p><p><strong>Methods: </strong>Longitudinal analysis of 4 waves (2013-2018) data. ACEs were derived from 2014 self-report life history survey. Latent growth curve modeling assessed the mediating effect of ADL and chronic diseases on the relationship between ACEs and self-rated health (SRH).</p><p><strong>Results: </strong>Among the 9575 individuals (mean [standard deviation, SD] age, 58.12 [8.73] years; 5174 [54.04 %] were females), the average ACEs score was 2.27 (SD = 1.75). Individuals with higher ACEs reported lower baseline SRH (β = -0.156, P < .001) and greater decline over time (β = -0.075, P < .001). Mediation analysis indicated that both baseline and longitudinal changes in ADL and chronic diseases (intercept and slope) partially mediated the association between ACE and the intercept of SRH, while ADL (intercept and slope) and chronic diseases (slope) fully mediated the association between ACE and the slope of SRH.</p><p><strong>Conclusions: </strong>ACEs were associated with poorer health status and accelerated decline, partially mediated by impaired ADL and increased chronic diseases. Interventions targeting ACE reduction, enhancing ADL, and managing chronic diseases could effectively improve the health of middle-aged and older adults.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":" ","pages":"100117"},"PeriodicalIF":4.3000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Adverse childhood experiences contribute to increased risk of health in middle and late life: The longitudinal mediating effect of activities of daily living and chronic diseases.\",\"authors\":\"Yijun Liu, Zhe Zhao, Shiyin Tian, Shaojie Yu, Juanfang Zhu, Yuanyuan Yang, Qinqin Jiang, Jinhai Sun, Shengjun Wang, Lei Yuan\",\"doi\":\"10.1016/j.inpsyc.2025.100117\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Adverse Childhood Experiences (ACEs) have long-term effects on health, but the mechanisms remain unclear.</p><p><strong>Objective: </strong>To investigate the association between ACEs and health status, exploring the potential mediating roles of activities of daily living (ADL) and chronic diseases.</p><p><strong>Participants and setting: </strong>9575 middle-aged and older adults from the China Health and Retirement Longitudinal Study (CHARLS).</p><p><strong>Methods: </strong>Longitudinal analysis of 4 waves (2013-2018) data. ACEs were derived from 2014 self-report life history survey. Latent growth curve modeling assessed the mediating effect of ADL and chronic diseases on the relationship between ACEs and self-rated health (SRH).</p><p><strong>Results: </strong>Among the 9575 individuals (mean [standard deviation, SD] age, 58.12 [8.73] years; 5174 [54.04 %] were females), the average ACEs score was 2.27 (SD = 1.75). Individuals with higher ACEs reported lower baseline SRH (β = -0.156, P < .001) and greater decline over time (β = -0.075, P < .001). Mediation analysis indicated that both baseline and longitudinal changes in ADL and chronic diseases (intercept and slope) partially mediated the association between ACE and the intercept of SRH, while ADL (intercept and slope) and chronic diseases (slope) fully mediated the association between ACE and the slope of SRH.</p><p><strong>Conclusions: </strong>ACEs were associated with poorer health status and accelerated decline, partially mediated by impaired ADL and increased chronic diseases. Interventions targeting ACE reduction, enhancing ADL, and managing chronic diseases could effectively improve the health of middle-aged and older adults.</p>\",\"PeriodicalId\":14368,\"journal\":{\"name\":\"International psychogeriatrics\",\"volume\":\" \",\"pages\":\"100117\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International psychogeriatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.inpsyc.2025.100117\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International psychogeriatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.inpsyc.2025.100117","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Adverse childhood experiences contribute to increased risk of health in middle and late life: The longitudinal mediating effect of activities of daily living and chronic diseases.
Background: Adverse Childhood Experiences (ACEs) have long-term effects on health, but the mechanisms remain unclear.
Objective: To investigate the association between ACEs and health status, exploring the potential mediating roles of activities of daily living (ADL) and chronic diseases.
Participants and setting: 9575 middle-aged and older adults from the China Health and Retirement Longitudinal Study (CHARLS).
Methods: Longitudinal analysis of 4 waves (2013-2018) data. ACEs were derived from 2014 self-report life history survey. Latent growth curve modeling assessed the mediating effect of ADL and chronic diseases on the relationship between ACEs and self-rated health (SRH).
Results: Among the 9575 individuals (mean [standard deviation, SD] age, 58.12 [8.73] years; 5174 [54.04 %] were females), the average ACEs score was 2.27 (SD = 1.75). Individuals with higher ACEs reported lower baseline SRH (β = -0.156, P < .001) and greater decline over time (β = -0.075, P < .001). Mediation analysis indicated that both baseline and longitudinal changes in ADL and chronic diseases (intercept and slope) partially mediated the association between ACE and the intercept of SRH, while ADL (intercept and slope) and chronic diseases (slope) fully mediated the association between ACE and the slope of SRH.
Conclusions: ACEs were associated with poorer health status and accelerated decline, partially mediated by impaired ADL and increased chronic diseases. Interventions targeting ACE reduction, enhancing ADL, and managing chronic diseases could effectively improve the health of middle-aged and older adults.
期刊介绍：
A highly respected, multidisciplinary journal, International Psychogeriatrics publishes high quality original research papers in the field of psychogeriatrics. The journal aims to be the leading peer reviewed journal dealing with all aspects of the mental health of older people throughout the world. Circulated to over 1,000 members of the International Psychogeriatric Association, International Psychogeriatrics also features important editorials, provocative debates, literature reviews, book reviews and letters to the editor.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
