Aging
Adverse Childhood Experiences and social isolation in older adults : JAGES 2016-2019 Anna Kosaka* Anna Kosaka Maho Haseda Kosuke Inoue Marisa Nishio Katsunori Kondo Naoki Kondo
Introduction
Social isolation adversely impacts physical and mental health. Adverse Childhood Experiences (ACEs), potentially traumatic experiences before the age of 18, may predispose individuals to social isolation in later life, whereas longitudinal studies exploring this association remain limited. This study examined the link between ACEs and social isolation among older adults in Japan.
Methods
We used data from the Japan Gerontological Evaluation Study (JAGES) in 2016 and 2019, including functionally independent individuals aged 65 and older not socially isolated in 2016. Social isolation was measured via the Social Isolation Index, with scores of three or more indicating isolation. ACEs were assessed using an eight-item questionnaire, with four or more ACEs categorized as high exposure. Multivariable modified Poisson regression was used to estimate risk ratios (RR), adjusting for demographic, socioeconomic, and health factors. We conducted subgroup analysis by sex and age and analyzed the association of each ACE item and social isolation.
Results
Among 8,358 study participants (mean age, 73.2 years; female, 40.9%), 528 (6.3%) reported ACEs ≥4 in 2016 and 579 (6.9%) became social isolation in 2019. High ACEs exposure was associated with an increased risk of social isolation (RR=1.55, 95% CI=1.19–2.00). The associations were stronger among females (RR=2.14, 95% CI=1.45–3.15) than males (RR=1.06, 95% CI=0.67-1.69; P for Interaction=0.004), and adults aged 65-75 years old (RR=1.95, 95%CI=1.39-2.73) than those aged 75-years old(RR=1.05, 95%CI=1.39-2.73; P for interaction=0.003). Among the ACE items, physical abuse (RR=2.11, 95% CI=1.27–3.52) was most associated with social isolation.
Conclusion
ACEs were associated with social isolation, particularly among female and adults aged 65-75 years old. These findings suggest that the prevention of social isolation in later life should start from childhood, preventing ACEs.