Association between adverse childhood experiences and intrinsic capacity impairment among middle-aged and older adults in China: A nationwide cross-sectional survey from CHARLS

BACKGROUND: There is still limited evidence regarding the association between adverse childhood experiences (ACEs) and intrinsic capacity (IC) impairment among middle-aged and older adults in China. This study aims to explore the relevance between ACEs and IC impairment, and to identify effect modifiers for this association, considering sociodemographic characteristics, behavioral characteristics, and health status. METHOD: This study analyzes 5325 participants aged 45 and above, which is based on data from the 2014 life history survey and 2015 follow-up survey of the CHARLS. Logistic regression models and restricted cubic spline analysis are employed to analyze the association between ACEs and IC impairment, supplemented by subgroup and interaction analyses to recognize effect modifiers in relation to sociodemographic characteristics, behavioral characteristics, and health status. RESULTS: Among 5325 participants, 94.91% had gone through at least one of the 20 ACEs, 48.36% had experienced four or more, and the prevalence of IC impairment was 60.07%. Participants who encountered four or more ACEs exhibited a 45.2% increased risk of IC impairment in contrast to those without any ACEs exposure. The number of ACEs and IC impairment revealed a substantial dose-response relationship (P < 0.05). Diabetes and night sleep duration were found to be important modifying factors by interaction analysis. CONCLUSION: Greater degrees of ACEs exposure are associated with a heightened risk of IC impairment in middle-aged and older adults aged 45 and above in China. These findings highlight the importance of targeted screening and life-course trauma-informed care for individuals with high ACEs exposure in effectively identifying those at high risk of IC impairment and promoting healthy aging.