Adverse childhood experiences and loneliness trajectory in middle-aged and older adults: A network analysis approach

OBJECTIVES: Loneliness is common across the world, and the factors driving its development are not yet fully understood. We used data from the China Health and Retirement Longitudinal Study (CHARLS) to assess the association between adverse childhood experiences (ACEs) and the trajectory of loneliness over time. STUDY DESIGN: Network analysis. METHODS: We used group-based trajectory modeling (GBTM) to identify patterns of loneliness trajectory from 2011 to 2020. Logistic regression models evaluated the associations between ACEs and different patterns of loneliness trajectory. Network analysis was conducted to identify the most central nodes. RESULTS: This study included 10,874 participants. Group-based trajectory modeling identified two distinct patterns of loneliness trajectories: persistently low and persistently high. Greater exposure to total ACEs (adjusted odds ratio (AOR) = 1.19, 95% confidence interval (95% CI): 1.13-1.25), threat-related ACEs (AOR = 1.21, 95% CI: 1.13-1.30), and deprivation-related ACEs (AOR = 1.22, 95% CI: 1.11-1.34) was significantly associated with the persistently high loneliness trajectory. Network analysis identified "household mental illness," "household violence," and "physical abuse" as the most central nodes. CONCLUSIONS: These findings highlight the importance of preventing ACEs and implementing universal life-course public health strategies to mitigate potential loneliness in middle and later adulthood among affected individuals.