Early-life determinants of cardiometabolic outcomes and accelerated biological ageing in Colombia

Adverse childhood experiences (ACEs) are critical early-life determinants of long-term health, yet their association with biological ageing and cardiometabolic risk remains poorly understood. We examined the association between ACEs, cardiometabolic outcomes and age acceleration among older adults in Colombia.

Data were drawn from 3,385 adults aged ≥60 years (1,726 women, 1,659 men) from the nationally representative Health, Well-Being, and Ageing Study (SABE-Colombia). Five ACEs before 15 years old were assessed: emotional abuse, domestic violence, poor self-reported health, scarcity of food, and forced childhood migration due to armed conflict. Biological ageing was estimated using Klemera-Doubal Method for Biological Age (∆KDMAge). Associations between ACEs and cardiometabolic outcomes (cardiovascular disease [CVD], diabetes, hypertension, and obesity) were evaluated using logistic and Poisson regression models; and associations with biological ageing using linear regression models, adjusting for sociodemographic factors.

Among women, emotional abuse (OR=1.68), domestic violence (OR=1.55), scarcity of food (OR=1.44), and poor health status (OR=1.66) were associated with increased odds of CVD (OR=1.68). Among men, forced childhood migration was associated with higher risks of diabetes (OR=1.60), CVD (OR=1.55), and hypertension (OR=1.43). Forced childhood migration was also associated with age acceleration (∆KDMAge β =1.52), with a stronger association in women (∆KDMAge β =2.67). Dose-response associations were observed between cumulative ACEs and CVD in women and hypertension in men.

Early-life adversity, particularly forced childhood migration, is associated with higher cardiometabolic risk and accelerated biological ageing in later life, emphasizing the long-term biological costs of social and political instability.