Loneliness links Adverse Childhood Experiences to Mortality Risk across 26 years

Objectives: Adverse Childhood Experiences (ACEs) are associated with increased mortality risk. Individuals with a history of certain adversity during childhood tend to report higher levels of loneliness in later life. In our pre-registered study, we examined whether loneliness mediates the ACEs to mortality risk relation. Methods: Participants were from the Midlife in the United States Survey (N = 4963; M [SD] 46.44 [12.52] years, 53.3% female). Follow-up period spanned 26 years. A comprehensive measure of ACEs was employed consisting of 20 ACEs from five categories: physical abuse, emotional abuse, socioeconomic disadvantage, adverse family structure, and poor health at age 16 years. Results: ACEs was a significant predictor of mortality risk. Loneliness mediated the ACEs-mortality risk relation. In other words, loneliness in adulthood accounted for the relation between ACEs and future death. These effects withstood a range of sensitivity checks and adjustments for important factors, such as social isolation. Discussion: Loneliness appears to be a central mechanism in the long-term impact of ACEs on longevity, such that, for adversity during childhood, loneliness experienced during adulthood may be a toxic pathway to future death.