Childhood adversity: A gateway to multimorbidity in older age?

Arch Gerontol Geriatr. Jan-Feb 2019;80:31-37. doi: 10.1016/j.archger.2018.10.003. Epub 2018 Oct 9.

Abstract

Background: Multimorbidity, or co-occurrence of several chronic diseases, has major consequences in terms of function, quality of life and mortality. Recent advances suggest that the aetiology of multimorbidity includes a life-long process. The purpose of this study was to determine the association between childhood adversity and multimorbidity in community-dwelling older adults, and to investigate variation in participants born immediately before, during and at the end of the Second World War.

Methods: Participants were 4731 community-dwelling older adults who enrolled in the Lausanne cohort 65+ study (Switzerland) at age 65-70 years in 2004/2009/2014. A baseline questionnaire provided several indicators of childhood adversity including premature birth, food restrictions, child labour, family economic environment, serious illness/accident, and stressful life events. Multimorbidity at age 67-72 years was defined as ≥2 active chronic diseases at the 2-year follow-up questionnaire.

Results: All childhood adversity indicators except premature birth were significantly associated with multimorbidity. Odds ratio (OR) ranged from 1.23 (P = 0.034) for poor family economic environment to 1.74 (P < 0.001) for stressful life events. In a multivariable model adjusted for socioeconomic status, health behaviours and stressful life events in adulthood (>16 years), a history of serious illness/accident (OR = 1.45; P < 0.001) and stressful life events (OR = 1.42; P = 0.001) in childhood remained significantly associated with multimorbidity. Comparisons between cohorts indicated substantial variations in the prevalence of childhood adversity indicators but similar associations with multimorbidity.

Conclusion: There was an independent association between childhood adversity and multimorbidity after age 65. This study encourages a comprehensive life-course perspective to better understand and potentially prevent multimorbidity.

Keywords: Epidemiology; Life-course; Multimorbidity; Public health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Child
  • Cohort Studies
  • Female
  • Health Behavior
  • Humans
  • Independent Living
  • Male
  • Multimorbidity*
  • Quality of Life
  • Social Class
  • Stress, Psychological / complications