Linking Adverse Childhood Experiences and Chronic Lung Diseases: The Mediating Role of Depression, Frailty, and Social Isolation

Objectives This study examined the association from Chronic lung diseases (CLDs) to Adverse childhood experiences (ACEs) with a specific focus on examining the potential mediating effects of depression, frailty, and social isolation. Methods Data for this retrospective cohort study were obtained from participants enrolled in the China Health and Retirement Longitudinal Study (CHARLS). This study estimated competing structural equation model (SEM) examining the associations from ACEs to CLDs, and the mediating roles of depressive, frailty and social isolation. Results This study found ACEs had significant direct ( β  = 0.024, p  < 0.001), and total ( β  = 0.034, p  = 0.003) effects on CLDs. ACEs had a significant indirect effect on CLDs through depression (β = 0.009, p  < 0.001), through Isolation (β = 0.003, p  = 0.809). ACEs exerted multi-step indirect effects on CLDs through various pathways. ACEs influenced CLDs indirectly through both Depression and Frailty (β < 0.001, p  < 0.001), through Depression and Isolation (β < 0.001, p  = 0.809), through Isolation and Frailty (β < 0.001, p  = 0.013). ACEs had a multi-step indirect effect on CLDs through Depression, Frailty, and Isolation (β < 0.001, p  = 0.024). Conclusions This study establishes a significant association between ACEs and CLDs, in the elderly population. Furthermore, depression, frailty and social isolation as three mediating factors in the ACEs and CLDs relationship.