Adverse childhood experiences and the development of multimorbidity across adulthood-a national 70-year cohort study.
Adverse childhood experiences and the development of multimorbidity across adulthood-a national 70-year cohort study.
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DOI：
10.1093/ageing/afad062
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发表时间：
2023-04-01
期刊：
影响因子：
6.7
通讯作者：
中科院分区：
文献类型：
--
作者：
研究不良童年经历 (ACE) 对成年后三十年中多种疾病发生率和发展的影响。样本：1946 年全国健康与发展调查的参与者，参加 1982 年 36 岁评估和后续评估（43、53、63、69 岁；N = 3,264，51% 男性）。前瞻性收集的九项 ACE 数据分为 (i) 社会心理、(ii) 父母健康和 (iii) 儿童健康。对于每组，我们计算了累积 ACE 分数，分为 0、1 和 ≥2 ACE。多重发病率估计为 18 种健康疾病的总分。使用系列横截面线性回归来评估随访期间分组的 ACE 与多发病之间的关联。使用 ACE 组的线性混合效应模型（根据性别和儿童社会经济环境进行调整），对随访期间多病轨迹中与 ACE 相关的变化进行了纵向分析。在整个随访过程中，社会心理和儿童健康 ACE 的积累与逐渐升高的多病评分相关。例如，具有≥2个心理社会ACE的人在36岁时经历的疾病比没有的人多0.20（95％CI 0.07，0.34），在69岁时上升到0.61（0.18，1.04）。所有三组ACE都与成年期更高的积累率和更高的多发病轨迹相关。例如，与没有心理社会 ACE 的个体相比，具有 ≥2 个社会心理 ACE 的个体在 36 岁至 43 岁之间罹患疾病的几率高出 0.13（−0.09，0.34），在 53 岁至 63 岁之间罹患疾病的几率高出 0.29（0.06，0.52），在 63 岁至 69 岁之间则罹患疾病的几率高出 0.30（0.09，0.52）。 ACE 与成年期和老年早期多种疾病发展的不平等加剧有关。公共卫生政策应旨在通过个人和人口层面的干预措施来减少这些差异。
To examine impact of adverse childhood experiences (ACE) on rates and development of multimorbidity across three decades in adulthood. 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). 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. 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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影响因子：
3.5
作者：
Lawn RB;Anderson EL;Suderman M;Simpkin AJ;Gaunt TR;Teschendorff AE;Widschwendter M;Hardy R;Kuh D;Relton CL;Howe LD
通讯作者：
Howe LD
影响因子：
5.3
作者：
Jones, Rebecca;Hardy, Rebecca;Thomas, Claudia
通讯作者：
Thomas, Claudia
影响因子：
4
作者：
Gambaro, Ludovica;Buttaro, Anthony, Jr.;Lennon, Mary Clare
通讯作者：
Lennon, Mary Clare
影响因子：
15.8
作者：
Khanolkar AR;Chaturvedi N;Kuan V;Davis D;Hughes A;Richards M;Bann D;Patalay P
通讯作者：
Patalay P
影响因子：
6.9
作者：
Colman, I.;Kingsbury, M.;Thompson, A. H.
通讯作者：
Thompson, A. H.