Adverse childhood experiences and the trajectory of social frailty among middle-aged and older adults in China.

BACKGROUND

Social frailty is a dynamic state of being at risk of losing or having already lost the resources critical for meeting basic social needs throughout life. Associations between adverse childhood experiences (ACEs) and the trajectory of social frailty among middle-aged and older Chinese individuals have not been well documented.

OBJECTIVE

We aimed to investigate the trajectory of social frailty, its association with ACEs, and the gender-specific difference in the association.

PARTICIPANTS AND SETTING

We included 4476 participants aged 45 years or older who were obtained from the China Health and Retirement Longitudinal Study (CHARLS).

METHODS

Analyses were conducted with data from four waves (2011, 2013, 2015, and 2018). The latent growth curve model was used to identify the trajectory of social frailty. A conditional model was used to examine the effects of ACEs on this trajectory. The Wald chi-square test was conducted to examine the gender differences in the relationship between ACEs and the trajectory of social frailty.

RESULTS

The trend of social frailty was rising as age increased. ACEs were significantly associated with social frailty at baseline (b = 0.048, SE = 0.014, p < 0.001). In the adjusted model, threat-related ACEs predicted the initial level of social frailty (b = 0.061, SE = 0.020, p = 0.002), and deprivation-related ACEs predicted the slope of social frailty (b = 0.018, SE = 0.008, p = 0.031). Additionally, there were no significant gender differences between ACEs and the trajectory of social frailty (p > 0.05).

CONCLUSIONS

The study revealed an upward trend in social frailty with age. ACEs were associated with the initial level of social frailty but did not have a lasting impact on its trajectory. There were no significant gender differences in the association. It is essential to identify individuals with ACEs and monitor their social frailty as they age, while developing interventions to mitigate the long-term effects of ACEs on social frailty.