Famine exposure in childhood and multimorbidity risk in older adults

BackgroundPrevious research on multimorbidity focused on patterns, prevalence, and correlation and studies on famine have primarily focused on single diseases, with limited research on its effect on multimorbidity, especially in China.AimsOur study aimed to examine the association between famine exposure and the risk of multimorbidity through a cross-sectional survey in older adults.MethodsA total of 1580 community-dwelling older people were included in this study. Famine exposure was classified as nonexposed, toddlers exposed (1-3 years old exposed), preschool-age children exposed (4-6 years old exposed), school-age children exposed (7-13 years old exposed), adolescent exposed (14 to 19 years old exposed), adult exposed (20 years and older exposed). Multimorbidity was defined as "the co-occurrence of at least two chronic conditions in the same individual" based on the data of 39 common diseases. The associations were presented using adjusted odds ratio (aOR) with corresponding 95% confidence intervals (CI), and statistical significance was determined at p < 0.05.ResultsThe results indicated that famine exposure substantially elevated the risk of multimorbidity. Compared with the nonexposed group, the risks of Cardiometabolic and Complex/multisystem multimorbidity were increased in the preschool (OR: 2.03, 95%CI: 1.01, 4.08) and school-age exposed groups (OR: 2.27, 95%CI: 1.06, 4.88), respectively. Specifically, early-life exposure to Chinese famine was associated with an increased risk of developing high blood pressure (OR: 1.46, 95%CI: 1.00-2.11), chronic pulmonary diseases/asthma (OR: 1.78, 95%CI: 1.02-3.12), fractures (OR: 1.865, 95%CI:1.14, 3.04), and cataracts (OR: 2.26, 95%CI:1.22, 4.19) in older adults.SummaryIndividuals exposed to famine in early childhood, especially during preschool and school-age years, significantly increased their risk of multimorbidity in adulthood. These findings highlight the need for targeted health interventions and long-term disease prevention strategies for individuals who experienced early-life nutritional deprivation.