Ren Ziyang, Sun Yuchun, Nie Lirong, Zhang Xuefen, Wang Linlin, Li Leah, Liu Jufen
Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, China.
School of Public Health, Shanxi Medical University, China.
J Affect Disord. 2025 Nov 1;388:119598. doi: 10.1016/j.jad.2025.119598. Epub 2025 Jun 4.
Large numbers of children with chronic diseases can now live into adulthood and older age. Poor childhood health is linked to adverse health events in later life, but the associations of childhood multimorbidity with depressive symptoms and functional limitations remain underexplored.
Data were from the Survey of Health, Ageing and Retirement in Europe, English Longitudinal Study of Ageing and Health and Retirement Study, which included samples from 31 countries (N = 138,540, aged 50 and older). Eight childhood chronic diseases diagnosed before age 15/16 were retrospectively reported, with 2 or more indicating childhood multimorbidity. Depressive symptoms (assessed by the Europe-depression Scale or the Centre for Epidemiologic Studies Depression Scale) and limitations in (instrumental) activities of daily living ([I]ADLs) and mobility-related limitations were recorded at multiple time points. Generalized estimating equations were used to estimate associations and weighted random-effect meta-analysis was performed to pool associations across countries.
Childhood multimorbidity was associated with depressive symptoms, ADL, IADL and mobility limitations, with odds ratios and 95 % confidence intervals of 1.74 (1.60-1.90), 1.75 (1.61-1.90), 1.73 (1.58-1.90), and 1.68 (1.50-1.89), respectively. The associations were similar for participants with and without adulthood multimorbidity (P for difference > 0.05). For ADL and IADL limitations, associations were more pronounced in adults aged<65y (P for difference = 0.008 and 0.014).
Misclassification bias of childhood diseases; scale-based outcomes; potential covariates were not adjusted; no data from low- and middle-income regions.
Childhood multimorbidity was associated with depressive symptoms and functional limitations in later life, which were more pronounced in the younger elderly.
现在大量患有慢性病的儿童能够活到成年及老年。儿童时期健康状况不佳与晚年不良健康事件相关，但儿童期多种疾病并存与抑郁症状及功能受限之间的关联仍未得到充分研究。
数据来自欧洲健康、老龄化与退休调查、英国老龄化纵向研究以及健康与退休研究，样本涵盖31个国家（N = 138540，年龄在50岁及以上）。回顾性报告了15/16岁之前诊断出的8种儿童慢性病，其中2种或更多表明儿童期多种疾病并存。在多个时间点记录抑郁症状（通过欧洲抑郁量表或流行病学研究中心抑郁量表评估）以及日常生活（工具性）活动受限情况和与行动相关的受限情况。使用广义估计方程来估计关联，并进行加权随机效应荟萃分析以汇总各国的关联。
儿童期多种疾病并存与抑郁症状、日常生活活动受限、工具性日常生活活动受限及行动受限相关，优势比及95%置信区间分别为1.74（1.60 - 1.90）、1.75（1.61 - 1.90）、1.73（1.58 - 1.90）和1.68（1.50 - 1.89）。对于患有和未患有成年期多种疾病并存的参与者，关联相似（差异P > 0.05）。对于日常生活活动受限和工具性日常生活活动受限，在65岁以下成年人中关联更为明显（差异P = 0.008和0.014）。
儿童疾病的错误分类偏差；基于量表的结果；未调整潜在协变量；缺乏低收入和中等收入地区的数据。
儿童期多种疾病并存与晚年抑郁症状及功能受限相关，在较年轻的老年人中更为明显。
