Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in China
Objectives: Adverse childhood experiences (ACEs) are associated with frailty, while the association with frailty state transitions and the role of social participation remain unclear. This study aimed to investigate the association between ACEs and frailty state transitions, alongside the moderating...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | The Journal of Nutrition, Health and Aging |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1279770724004883 |
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| author | Jiajia Li Heming Pei Xiaojin Yan Yue Wei Gong Chen Lijun Pei |
| author_facet | Jiajia Li Heming Pei Xiaojin Yan Yue Wei Gong Chen Lijun Pei |
| author_sort | Jiajia Li |
| collection | DOAJ |
| description | Objectives: Adverse childhood experiences (ACEs) are associated with frailty, while the association with frailty state transitions and the role of social participation remain unclear. This study aimed to investigate the association between ACEs and frailty state transitions, alongside the moderating effect of social participation Methods: Data from 9,621 adults aged 45 and older from the China Health and Retirement Longitudinal Study (2011–2020) were analyzed. Frailty was measured with the frailty index, while ACEs and social participation were measured with a validated questionnaire. The association between ACEs and frailty state transitions was estimated using multi-state models. An interaction analysis were used to examine the moderating effects of social participation. Results: Participants with higher ACEs scores (≥4) were associated with an increased probability of forward transition (robust to pre-frail, HR = 1.37, 95%CI: 1.21–1.54; prefrail to frail, HR = 1.39, 95%CI: 1.18–1.63) and decreased probability of backward transition (pre-frail to robust, HR = 0.64, 95%CI: 0.55–0.76). Additionally, participants with moderate and high level social participation were associated with an increased probability of backward transition (pre-frail to robust, HR = 1.11, 95%CI: 1.01–1.23; frail to pre-frail, HR = 1.17, 95%CI: 1.02–1.33, respectively). Social participation moderated the association between ACEs exposure and frailty (P for interaction <0.05), while participants with lower ACEs scores (1 and 2) and high social participation were associated with an increased probability of transition from frail to pre-frail (HR = 1.26, 95%CI: 1.04–1.89 and HR = 1.15, 95%CI: 1.08–1.69). Conclusions: High ACEs scores were associated with an increased likelihood of adverse frailty development. Older adults with ACEs exposure might benefit from intervention strategies to improve social participation. |
| format | Article |
| id | doaj-art-7b11228095034cb78625f6a8783da672 |
| institution | OA Journals |
| issn | 1760-4788 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Journal of Nutrition, Health and Aging |
| spelling | doaj-art-7b11228095034cb78625f6a8783da6722025-08-20T02:21:06ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882024-12-01281210040010.1016/j.jnha.2024.100400Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in ChinaJiajia Li0Heming Pei1Xiaojin Yan2Yue Wei3Gong Chen4Lijun Pei5Institute of Population Research, Peking University, Beijing, ChinaButler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, United States; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United StatesInstitute of Population Research, Peking University, Beijing, ChinaInstitute of Population Research, Peking University, Beijing, ChinaInstitute of Population Research, Peking University, Beijing, China; Corresponding author.Institute of Population Research, Peking University, Beijing, China; Corresponding author.Objectives: Adverse childhood experiences (ACEs) are associated with frailty, while the association with frailty state transitions and the role of social participation remain unclear. This study aimed to investigate the association between ACEs and frailty state transitions, alongside the moderating effect of social participation Methods: Data from 9,621 adults aged 45 and older from the China Health and Retirement Longitudinal Study (2011–2020) were analyzed. Frailty was measured with the frailty index, while ACEs and social participation were measured with a validated questionnaire. The association between ACEs and frailty state transitions was estimated using multi-state models. An interaction analysis were used to examine the moderating effects of social participation. Results: Participants with higher ACEs scores (≥4) were associated with an increased probability of forward transition (robust to pre-frail, HR = 1.37, 95%CI: 1.21–1.54; prefrail to frail, HR = 1.39, 95%CI: 1.18–1.63) and decreased probability of backward transition (pre-frail to robust, HR = 0.64, 95%CI: 0.55–0.76). Additionally, participants with moderate and high level social participation were associated with an increased probability of backward transition (pre-frail to robust, HR = 1.11, 95%CI: 1.01–1.23; frail to pre-frail, HR = 1.17, 95%CI: 1.02–1.33, respectively). Social participation moderated the association between ACEs exposure and frailty (P for interaction <0.05), while participants with lower ACEs scores (1 and 2) and high social participation were associated with an increased probability of transition from frail to pre-frail (HR = 1.26, 95%CI: 1.04–1.89 and HR = 1.15, 95%CI: 1.08–1.69). Conclusions: High ACEs scores were associated with an increased likelihood of adverse frailty development. Older adults with ACEs exposure might benefit from intervention strategies to improve social participation.http://www.sciencedirect.com/science/article/pii/S1279770724004883FrailtyACEsSocial participationMulti-state model |
| spellingShingle | Jiajia Li Heming Pei Xiaojin Yan Yue Wei Gong Chen Lijun Pei Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in China The Journal of Nutrition, Health and Aging Frailty ACEs Social participation Multi-state model |
| title | Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in China |
| title_full | Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in China |
| title_fullStr | Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in China |
| title_full_unstemmed | Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in China |
| title_short | Adverse Childhood Experiences and Social Participation on Frailty State Transitions among middle-aged and older adults: evidence from a 10-year prospective study in China |
| title_sort | adverse childhood experiences and social participation on frailty state transitions among middle aged and older adults evidence from a 10 year prospective study in china |
| topic | Frailty ACEs Social participation Multi-state model |
| url | http://www.sciencedirect.com/science/article/pii/S1279770724004883 |
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