Aging
The impact of adverse childhood experiences on functional impairment in a diverse cohort of older adults Gina E. Nam* Gina Nam Nam Nam Nam Nam Nam Nam USC Leonard Davis School of Gerontology
Background: The possible impact of childhood adversity on functional impairment in late life is unknown.
Methods: We included community-dwelling adults aged 65+ from the Kaiser Healthy Aging and Different Life Experiences Study. Childhood adversity was defined as reporting at least one adverse experience (parental separation, parental remarriage, witnessed domestic violence, family substance abuse, parental job loss, parental incarceration, and serious illness of a family member) versus none. Functional impairment was a composite score summing 12 Likert (0-4) items of activities of daily living (ADL), instrumental ADL, and mobility domains (range: 0-36), measured over up to 4 waves (2017-2025). We fit generalized estimating equations for functional impairment scores by childhood adversity, adjusting for follow-up time, early-life demographic, and socioeconomic variables. We estimated marginal mean functional impairment scores by childhood adversity status at each study wave, accounting for attrition (dropout/death), and calculated mean differences.
Results: Among 1,709 participants (mean [SD] baseline age, 76.0 [6.8] years; 60% female), 67% reported experiencing at least one type of childhood adversity. Mean baseline functional impairment score was 3.2 (SD = 4.3). Those with a history of childhood adversity had higher baseline levels of functional impairment than those without adversity (mean difference = 0.85; 95% CI, 0.44-1.26). Average functional impairment scores increased over time for both groups, and differences in change between exposure groups were small (Figure). By wave 4 (5.2 years), mean difference in functional impairment between those with and without childhood adversity was 0.90 (95% CI, 0.36-1.45).
Conclusion: Childhood adversity was associated with higher levels of functional impairment, with differences persisting over follow-up. More research is needed to understand the impact of childhood adversity on functional impairment over the lifecourse.
