The association between adverse childhood experiences and chronic respiratory diseases in the Chinese middle-aged and elderly population.

BACKGROUND

The relationship between adverse childhood experiences (ACEs) and respiratory diseases in the Chinese middle-aged and elderly population remains under explored. Furthermore, the potential moderating effects of social demographics factors and health-related behaviors on these associations have not been thoroughly investigated.

METHODS

The association between ACEs and chronic respiratory diseases was evaluated using the validated China Health and Retirement Longitudinal Study(CHARLS)baseline questionnaire2, with data analyzed through a logistic regression model. Stratification analysis and interaction tests were used to assess the influence of social demographics and health behavior factors on these associations.

RESULTS

Individuals exposed to four or more ACEs had a 48% higher likelihood of developing chronic respiratory diseases compared to those without ACEs exposure (aOR = 1.48, 95% CI: 1.10-1.99). Notably, a synergistic effect was observed where long sleep duration (LS,≥ 9 h/day) combined with ACEs exposure further increased the risk of these diseases.

LIMITATIONS

As a cross-sectional study, causal relationships between the variables cannot be inferred. The study is also limited by potential recall bias in retrospective data and the possibility of measurement errors due to self-reported asthma or chronic obstructive pulmonary disease(COPD)diagnoses.

CONCLUSIONS

In the middle-aged and elderly population of China, a significant positive correlation exists between ACEs exposure and the prevalence of chronic respiratory diseases. These findings suggest that integrating ACEs assessment into the prevention and control strategies for chronic respiratory diseases could help identify high-risk subgroups. In alignment with China's public health service initiatives, a multi-stage health management framework incorporating ACEs screening is recommended to address the disease burden associated with population aging.