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Adverse childhood experiences and trajectories of multimorbidity in individuals aged over 50: Evidence from the English Longitudinal Study of Ageing

Taylor, Katherine; Demakakos, Panayotes; (2024) Adverse childhood experiences and trajectories of multimorbidity in individuals aged over 50: Evidence from the English Longitudinal Study of Ageing. Child Abuse and Neglect , 149 , Article 106653. 10.1016/j.chiabu.2024.106653. Green open access

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Abstract

Background: Adverse childhood experiences (ACE) are important for chronic diseases yet their association with multimorbidity remains understudied. Few studies consider the complexity of multimorbidity or observe multimorbidity development over time. Objective: We investigated whether ACE were associated with multimorbidity at baseline and over a 12-year follow-up period. Participants and setting: 5326 participants aged over 50 were obtained from the English Longitudinal Study of Ageing (ELSA). Methods: An ACE summary score was derived using eight ACE items measuring abuse, social care, and household dysfunction. From repeated measurements of 29 chronic conditions over a 12-year period (2008–2019) we derived two multimorbidity measures: number of chronic diseases and number of chronic disease categories. We used multinomial logistic regression to assess associations between ACE and both measures. Mixed effects models were estimated to examine trajectories of multimorbidity by ACE over time. Results: Graded associations between ACE and multimorbidity were observed. Compared to those without ACE, participants with ≥3 ACE had three times the risk of having ≥3 chronic diseases (RRR 3.06, 95 % CI 1.85–5.05) and falling into ≥3 chronic disease categories (RRR 2·93 95 % CI 1·74–4·95). Graded associations persisted during 12-year follow-up, though differences in multimorbidity between those with ≥3 ACE and those without ACE remained constant (B 0.02, 95 % CI 0·01–0·03, and B −0·01, 95 % CI −0·02–0·00, number of chronic conditions and chronic condition categories respectively). Conclusion: ACE are associated with multimorbidity risk and complexity, associations arising before the age of 50. Early intervention amongst those with ACE could attenuate this association.

Type: Article
Title: Adverse childhood experiences and trajectories of multimorbidity in individuals aged over 50: Evidence from the English Longitudinal Study of Ageing
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.chiabu.2024.106653
Publisher version: http://dx.doi.org/10.1016/j.chiabu.2024.106653
Language: English
Additional information: © 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Multimorbidity, Adverse childhood experience, Childhood maltreatment, Adult health
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10186497
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