Adverse childhood experiences and multimorbidity of internalising and cardiometabolic conditions in mid to older age

Multimorbidity of internalising and cardiometabolic conditions (ICM-MM) is the most common combination of mental and physical health conditions in older age. Few studies have examined the likelihood that individuals with adverse childhood experiences (ACEs) such as abuse or neglect will develop ICM-MM in mid to late adulthood, or gender disparities.

Methods

UK Biobank participants (n = 157,184, mean age 55.94, SD= 7.74; 68186 males and 88998 females) reported on ACEs as well as sociodemographic and lifestyle factors. Diagnoses of internalising conditions (depression and anxiety) and cardiometabolic conditions (hypertension, obesity, type 2 diabetes, dyslipidaemia and chronic kidney disease) were obtained through linked electronic healthcare records. Logistic regression models tested associations between ACEs and internalising conditions, cardiometabolic conditions and ICM-MM, accounting for gender differences and sociodemographic and lifestyle factors.

Results

ACEs were associated with all individual and multimorbid presentations. Stronger associations were found with internalising conditions (OR 1.84) and ICM-MM (OR range 1.73-2.15) than cardiometabolic conditions (OR range 1.08-1.44). Females were more likely to report most ACEs, but health risks following ACEs were similar for both genders. The associations remained when accounting for sociodemographic and lifestyle factors, including gender, age, socioeconomic status, ethnicity, diet, alcohol intake, smoking status and physical activity levels.

Conclusions

This is the first study to report associations between ACEs and the most common type of physical and mental health multimorbidity in mid to late adulthood. The results highlight the importance of early ACE intervention and trauma-informed healthcare.