Abstract
This study examined the associations between childhood experiences and frailty trajectory among middle-aged and older Chinese adults. Data were derived from the China Health and Retirement Longitudinal Study. We used data from all four waves (i.e., 2011, 2013, 2015, 2018) and the life history survey in 2014. Data for 10,963 respondents were included. Latent growth curve models were conducted to examine the proposed model. The results show that adverse childhood experiences, self-rated childhood socioeconomic status, and the objective indicators of childhood health and health care were associated with both the baseline level and change rate of frailty. The educational attainment of fathers and perceived childhood health and healthcare conditions were associated with baseline frailty only. Our findings highlight the crucial role of childhood antecedents in the progression of frailty in later life. We further found strong evidence that childhood is an essential life stage for human development. Future social policies and interventions should use childhood experiences as a screening tool and promote child protection, health education, and life course interventions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The datasets are available in the CHARLS repository, [http://charls.pku.edu.cn].
References
Alvarado BE, Zunzunegui M-V, Béland F, Bamvita J-M (2008) Life course social and health conditions linked to frailty in Latin American older men and women. The journals of gerontology. Ser Biol Sci Med Sci 63:1399–1406. https://doi.org/10.1093/gerona/63.12.1399
Ben-Shlomo Y, Kuh D (2002) A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol 31:285–293. https://doi.org/10.1093/ije/31.2.285
Berens AE, Jensen SKG, Nelson CA 3rd (2017) Biological embedding of childhood adversity: from physiological mechanisms to clinical implications. BMC Med 15:135. https://doi.org/10.1186/s12916-017-0895-4
Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, McCoy DC, Fink G, Shawar YR, Shiffman J, Devercelli AE, Wodon QT, Vargas-Barón E, Grantham-McGregor S, Committee LECDSS (2017) Early childhood development coming of age: science through the life course. The Lancet 389:77–90. https://doi.org/10.1016/s0140-6736(16)31389-7
Chamberlain AM, Rutten LJF, Manemann SM, Yawn BP, Jacobson DJ, Fan C, Grossardt BR, Roger VL, Sauver JLS (2016) Frailty Trajectories in an Elderly Population-Based Cohort. J Am Geriatr Soc 64:285–292. https://doi.org/10.1111/jgs.13944
Dannefer D (2003) Cumulative advantage/disadvantage and the life course: cross-fertilizing age and social science theory. The journals of gerontology. Ser Psychol Sci Soc Sci 58:S327–S337. https://doi.org/10.1093/geronb/58.6.s327
Elder GH, Johnson MK, Crosnoe R (2003) The emergence and development of life course theory. In: Mortimer JT, Shanahan MJ (eds) Handbook of the Life Course. Springer, US, Boston, pp 3–19
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 14:245–258. https://doi.org/10.1016/s0749-3797(98)00017-8
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA (2001) Frailty in older adults: evidence for a phenotype. the journals of gerontology. Ser Biol Sci Med Sci 56:M146–M156. https://doi.org/10.1093/gerona/56.3.m146
Hair JF, Black WC, Babin BJ, Anderson RE (2010) Multivariate Data Analysis, 7th edn. Prentice-Hall, Upper Saddle River
Hu B (2021) Childhood adversity and healthy ageing: a study of the Chinese older population. Eur J Ageing 18:523–535. https://doi.org/10.1007/s10433-021-00608-8
Jung Y, Lyu J, Kim G (2022) Multi-group frailty trajectories among older koreans: results from the korean longitudinal study of aging. Arch Gerontol Geriatr 98:104533. https://doi.org/10.1016/j.archger.2021.104533
Kalmakis KA, Chandler GE (2015) Health consequences of adverse childhood experiences: a systematic review. J Am Assoc Nurse Pract 27:457–465. https://doi.org/10.1002/2327-6924.12215
Kendig H, Gong CH, Yiengprugsawan V, Silverstein M, Nazroo J (2017) Life course influences on later life health in China: childhood health exposure and socioeconomic mediators during adulthood. SSM-Popul Health 3:795–802. https://doi.org/10.1016/j.ssmph.2017.10.001
Kline RB (2011) Principles and practice of structural equation modeling, 3rd edn. The Guilford Press, New York
Ko CY, Koyama M, Sng T-H (2018) Unified China and Divided Europe. Int Econ Rev 59:285–327. https://doi.org/10.1111/iere.12270
Li Y, Xue Q-L, Odden MC, Chen X, Wu C (2020) Linking early life risk factors to frailty in old age: evidence from the China Health and Retirement Longitudinal Study. Age Ageing 49:208–217. https://doi.org/10.1093/ageing/afz160
Lin L, Sun W, Lu C, Chen W, Guo VY (2022) Adverse childhood experiences and handgrip strength among middle-aged and older adults: a cross-sectional study in China. BMC Geriatr 22:118. https://doi.org/10.1186/s12877-022-02796-z
Linden BWAVD, Sieber S, Cheval B, Orsholits D, Guessous I, Gabriel R, Arx MV, Kelly-Irving M, Aartsen M, Blane D, Boisgontier MP, Courvoisier D, Oris M, Kliegel M, Cullati S (2020) Life-course circumstances and frailty in old age within different European welfare regimes: a longitudinal study with share. the journals of gerontology. Ser Psychol Sci Soc Sci 75:1326–1335. https://doi.org/10.1093/geronb/gbz140
Liu H, Chen B, Li Y, Morrow-Howell N (2022) Neighborhood resources associated with frailty trajectories over time among community-dwelling older adults in China. Health Place 74:102738. https://doi.org/10.1016/j.healthplace.2021.102738
Lyu J, Burr JA (2016) Socioeconomic status across the life course and cognitive function among older adults: an examination of the latency, pathways, and accumulation hypotheses. J Aging Health 28:40–67. https://doi.org/10.1177/0898264315585504
Mian O, Anderson LN, Belsky DW, Gonzalez A, Ma J, Sloboda DM, Bowdish DME, Verschoor CP (2021) Associations of adverse childhood experiences with frailty in older adults: a cross-sectional analysis of data from the canadian longitudinal study on aging. Gerontology. https://doi.org/10.1159/000520327
National Bureau of Statistics of China (1988) Main data of the first National census —— Total number of households and total population. China Prospect Publishing House, Beijing, China Population Statistics Yearbook, p 272
National Health Commission of the People's Republic of China (2006) Guidelines for the prevention and control of overweight and obesity in Chinese adults. People's Medical Publishing House, Beijing, pp 3
Oh DL, Jerman P, Marques SS, Koita K, Boparai SKP, Harris NB, Bucci M (2018) Systematic review of pediatric health outcomes associated with childhood adversity. BMC Pediatr 18:83. https://doi.org/10.1186/s12887-018-1037-7
Pan Y (2020) Late-life cognition: do childhood conditions play any role? China Econ Rev. https://doi.org/10.1016/j.chieco.2020.101541
Pan C, Wang C, Shrestha B, Wang P (2021) 3-D health trajectories and related childhood predictors among older adults in China. Sci Rep 11:9874. https://doi.org/10.1038/s41598-021-89354-6
Phillips D, Green H, Petrosyan S, Shao K, Wilkens J, Lee J (2021) Harmonized CHARLS Documentation, Version D (2011-2018).https://charls.charlsdata.com/pages/data/111/en.html. Accessed 1 March 2022
Raymond E, Reynolds CA, Aslan AKD, Finkel D, Ericsson M, Hägg S, Pedersen NL, Jylhävä J (2020) Drivers of Frailty from adulthood into old age: results from a 27-year longitudinal population-based study in Sweden. the journals of gerontology. Ser Biol Sci Med Sci 75:1943–1950. https://doi.org/10.1093/gerona/glaa106
Rockwood K, Mitnitski A (2007) Frailty in relation to the accumulation of deficits. the journals of gerontology. Ser Biol Sci Med Sci 62:722–727. https://doi.org/10.1093/gerona/62.7.722
Rockwood K, Andrew M, Mitnitski A (2007) A comparison of two approaches to measuring frailty in elderly people. The journals of gerontology. Ser Biol Sci Med Sci 62:738–743. https://doi.org/10.1093/gerona/62.7.738
Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A (2005) A global clinical measure of fitness and frailty in elderly people. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 173:489–495. https://doi.org/10.1503/cmaj.050051
Shi Z, Wu C (2020) Early life adversity and health inequality: a dual interaction model. J Chin Sociol. https://doi.org/10.1186/s40711-020-00121-y
The Xinhua News Agency (2018) The elderly will account for about one third of the total population in China by 2050. Xinhuanet. http://www.xinhuanet.com/politics/2018-07/19/c_1123151410.htm. Accessed 25 May 2022
Theou O, Brothers TD, Mitnitski A, Rockwood K (2013) Operationalization of frailty using eight commonly used scales and comparison of their ability to predict all-cause mortality. J Am Geriatr Soc 61:1537–1551. https://doi.org/10.1111/jgs.12420
Wang Q, Shen JJ (2016) childhood health status and adulthood cardiovascular disease morbidity in rural China: are they related? Int J Environ Res Public Health. https://doi.org/10.3390/ijerph13060565
Wang Y, Chen Z, Zhou C (2021) Social engagement and physical frailty in later life: does marital status matter? BMC Geriatr 21:248. https://doi.org/10.1186/s12877-021-02194-x
Wu C, Smit E, Xue Q-L, Odden MC (2017) Prevalence and correlates of frailty among community-dwelling chinese older adults: the China health and retirement longitudinal study. the journals of gerontology. Ser Biol Sci Med Sci 73:102–108. https://doi.org/10.1093/gerona/glx098
Yang L, Wang Z (2020) Early-life conditions and cognitive function in middle-and old-aged Chinese adults: a longitudinal study. Int J Environ Res Public Health 17:3451. https://doi.org/10.3390/ijerph17103451
Yu R, Wong M, Chong KC, Chang B, Lum CM, Auyeung TW, Lee J, Lee R, Woo J (2018) Trajectories of frailty among Chinese older people in Hong Kong between 2001 and 2012: an age-period-cohort analysis. Age Ageing 47:254–261. https://doi.org/10.1093/ageing/afx170
Yuan K-H, Bentler PM (2000) Three likelihood-based methods for mean and covariance structure analysis with nonnormal missing data. Sociol Methodol 30:165–200. https://doi.org/10.1111/0081-1750.00078
Yuan K-H, Yang-Wallentin F, Bentler PM (2012) ML versus MI for missing data with violation of distribution conditions. Sociol Methods Res 41:598–629. https://doi.org/10.1177/0049124112460373
Zhang Y (2020a) Communiqué of the seventh national population census (No. 2)—Basic information of the national population. In: Zhang Y (ed) Key data from the Seventh National Population Census. China Statistic Publishing House, Beijing, pp 50–54
Zhang Y (2020b) Communiqué of the seventh national population census (No. 5)—age composition. In: Zhang Y (ed) Key data from the Seventh National Population Census. China Statistic Publishing House, Beijing, pp 66–71
Zhang J, Lu N (2021) The association between childhood conditions and heart disease among middle-aged and older population in China: a life course perspective. BMC Geriatr 21:184. https://doi.org/10.1186/s12877-021-02134-9
Zhang Z, Liu J, Li L, Xu H (2018) the long arm of childhood in china: early-life conditions and cognitive function among middle-aged and older adults. J Aging Health 30:1319–1344. https://doi.org/10.1177/0898264317715975
Zhao Y, Hu Y, Smith JP, Strauss J, Yang G (2014) Cohort profile: the china health and retirement longitudinal study (CHARLS). Int J Epidemiol 43:61–68. https://doi.org/10.1093/ije/dys203
Zheng X, Fang Z, Shangguan S, Fang X (2021) Associations between childhood maltreatment and educational, health and economic outcomes among middle-aged Chinese: The moderating role of relative poverty. Child Abuse Negl 130:105162. https://doi.org/10.1016/j.chiabu.2021.105162
Acknowledgements
This analysis uses data or information from the 2014 life history survey of the China Health and Retirement Longitudinal Study (CHARLS) and the Harmonized CHARLS dataset and Codebook, Version D as of June 2021 developed by the Gateway to Global Aging Data. The development of the Harmonized CHARLS was funded by the National Institute on Aging (R01 AG030153, RC2AG036619, R03 AG043052). For more information, please refer to https://g2aging.org/. We thank the CHARLS research team and field team for collecting the data and making the data publicly accessible.
Funding
This work was supported by fund for building world-class universities (disciplines) of Renmin University of China.
Author information
Authors and Affiliations
Contributions
YY contributed to statistical analysis, original draft preparation and writing, and revision. LC contributed to statistical analysis and revision. NL contributed to study design, supervision, data analysis, and paper writing and revision.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no competing interests to declare that are relevant to the content of this article.
Ethical approval
Was obtained from the Ethical Review Committee of Peking University.
Additional information
Responsible Editor: Héctor Pifarré i Arolas.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Appendices
Appendix 1
See Table 3.
Appendix 2
See Table 4.
Appendix 3
See Table 5.
Appendix 4
See Fig. 2.
Distribution of frailty index
Appendix 5
See Fig. 3.
The impact of different levels of ACEs, self-rated childhood SES, father’s education, self-rated childhood health, and objective health and health care on frailty trajectory
Appendix 6
See Table 6.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Yan, Y., Cai, L. & Lu, N. Childhood experiences and frailty trajectory among middle-aged and older adults in China. Eur J Ageing 19, 1601–1615 (2022). https://doi.org/10.1007/s10433-022-00746-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10433-022-00746-7