Abstract
BackgroundExposure to adverse childhood experiences (ACEs) may lead to stress-induced upregulation of inflammatory and neuroendocrine processes. However, it remains unclear whether such effects persist into later life, and which dimensions of ACEs might have the strongest impact on these biological mechanisms. Therefore, this study investigated the effects of ACEs on C-reactive protein (CRP) and hair cortisol in a large sample of older adults, distinguishing between cumulative exposure and dimensions of ACEs. MethodsWe utilised data from the English Longitudinal Study of Ageing. ACEs were assessed through retrospective reports at wave 3(2006/07). CRP (N = 4198) was measured at waves 4(2008/09) and 6(2012/13), and hair cortisol (N = 3357) at wave 6. The effects of ACEs cumulative exposure were examined using linear and ordinal logistic regression analysis. ACEs dimensions (i.e. threat, household dysfunction, low parental bonding, and loss of an attachment figure) were identified using explorative and confirmatory factor analysis with cross-validation. All analyses were adjusted for relevant confounders. ResultsParticipants with three or more ACEs had higher CRP levels at wave 4 and an elevated risk of high CRP concentrations across waves 4 and 6 compared with those who did not experience any ACEs. The four ACEs dimensions were all positively associated with both CRP outcomes and had similar effect sizes. In contrast, neither the cumulative score nor the dimensions of ACEs were significantly related to hair cortisol. However, there was a positive, yet small, interaction effect between ACEs and age on hair cortisol. ConclusionOlder adults who retrospectively reported three or more ACEs had chronically elevated CRP levels and exhibited a slightly steeper increase in hair cortisol with age. Different dimensions of ACEs had similar associations with the biomarkers.
Highlights
A large body of research has made it clear that adverse childhood experiences (ACEs) play a pivotal role in shaping adult health outcomes throughout the life course (Felitti and Anda, 2009)
In relation to the ACEs cumulative score, we found elevated C-reactive protein (CRP) values at wave 4 and higher CRP levels across waves 4 and 6 in participants reporting three or more ACEs compared with those who did not experience any ACEs, independently of demographic, socioeconomic, lifestyle, and medication confounders
Our results extend the current evidence base since they demonstrate that the relationship between ACEs and the inflammatory system is likely to persist into later life
Summary
A large body of research has made it clear that adverse childhood experiences (ACEs) play a pivotal role in shaping adult health outcomes throughout the life course (Felitti and Anda, 2009). Exposure to stressful circumstances activates sympathetic nervous system circuits and stimulates the release of corticotropin-releasing hormone (CRH) from the hypothalamus This in turn triggers a cascade of hormonal reactions resulting in increased production of glucocorticoids from the HPA-axis and greater levels of proinflammatory cytokines in the brain and peripherally (Miller et al, 2009). Exposure to adverse childhood experiences (ACEs) may lead to stress-induced upregulation of inflammatory and neuroendocrine processes. It remains unclear whether such effects persist into later life, and which dimensions of ACEs might have the strongest impact on these biological mechanisms. Conclusion: Older adults who retrospectively reported three or more ACEs had chronically elevated CRP levels and exhibited a slightly steeper increase in hair cortisol with age. Different dimensions of ACEs had similar associations with the biomarkers
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