Adverse childhood experiences and trajectories of chronic diseases: A population-base longitudinal study

Adverse childhood experiences (ACEs) have far-reaching effects on health outcomes. This study aimed to evaluate the associations of ACEs with trajectories and number of chronic diseases.

Cohort study.

Participants aged 45 years or older of China Health and Retirement Longitudinal Study were included. Ten kinds of ACEs encountered before 17 years old were calculated. Number of chronic diseases were assessed by 14 kinds of self-reported or proxy-reported diagnosed chronic diseases. The associations of specific types and number of ACEs with trajectories and number of chronic diseases were analyzed with latent class trajectory model, multinomial Logistic regression, and general estimating equation.

Four trajectories of chronic diseases were identified in 12157 participants. With the reference of low baseline and persistent growth trajectory, those encountered physical abuse, domestic violence, household mental illness, and parental death had higher risks of high baseline and transient growth trajectory, middle baseline and accelerated growth trajectory of chronic diseases (ORs = 1.18-1.65). Compared to those without ACEs, those with 1 and above kinds of ACEs had elevated risks of middle baseline and persistent growth, high baseline and transient growth trajectory, middle baseline and accelerated growth trajectory of chronic diseases (ORs = 1.15-2.71). Physical abuse, domestic violence, bullying, household mental illness, parental death, and exposure of 2 and above kinds of ACEs increased the number of chronic diseases (β = 0.09-0.62). Associations of ACEs with trajectories and number of chronic diseases were more salient in women than men.

Different types and number of ACEs were related to trajectories of chronic diseases, especially in women. Early, comprehensive, and joint actions should be taken to prevent chronic diseases from a life-course perspective.