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TL;DR
Participants were 45–85 years at recruitment, when allostatic load and social engagement were assessed, and 3 years older at follow-up, when ACEs and multimorbidity were measured.
Psychological Medicine · 6 authors, 3 centres
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Participants were 45–85 years at recruitment, when allostatic load and social engagement were assessed, and 3 years older at follow-up, when ACEs and multimorbidity were measured.
Participants were 45–85 years at recruitment, when allostatic load and social engagement were assessed, and 3 years older at follow-up, when ACEs and multimorbidity were measured. Structural equation modeling was used with adjustment for concurrent lifestyle confounds. ACEs were directly associated with multimorbidity (β=0.12, 95% CI 0.11–0.13). Indirectly, ACEs were related to lower social engagement (β=−0.14, 95% CI −0.16 to −0.12), which was in turn related to multimorbidity (β=−0.10, 95% CI −0.12 to −0.08). ACEs were also related to higher allostatic load (β=0.04, 95% CI 0.03–0.05), which was related to multimorbidity (β=0.16, 95% CI 0.15–0.17). The mediation model was significant for both males and females and across age cohorts, with qualifications in the oldest stratum (age 75–85). The study provides the first empirical demonstration of mediated pathways between early adversity and adult multimorbidity.