The effect of unhealthy lifestyle on the association between adverse childhood experiences and multimorbidity

FENG Hongman; XU Xianghui; LIU Mingyue; CHEN Xinyang; LI Xiaoming

doi:10.16462/j.cnki.zhjbkz.2025.08.017

Volume 29 Issue 8

Aug. 2025

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FENG Hongman, XU Xianghui, LIU Mingyue, CHEN Xinyang, LI Xiaoming. The effect of unhealthy lifestyle on the association between adverse childhood experiences and multimorbidity[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(8): 974-981. doi: 10.16462/j.cnki.zhjbkz.2025.08.017

Citation:

FENG Hongman, XU Xianghui, LIU Mingyue, CHEN Xinyang, LI Xiaoming. The effect of unhealthy lifestyle on the association between adverse childhood experiences and multimorbidity[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(8): 974-981. doi: 10.16462/j.cnki.zhjbkz.2025.08.017

Citation:

FENG Hongman, XU Xianghui, LIU Mingyue, CHEN Xinyang, LI Xiaoming. The effect of unhealthy lifestyle on the association between adverse childhood experiences and multimorbidity[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(8): 974-981. doi: 10.16462/j.cnki.zhjbkz.2025.08.017

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The effect of unhealthy lifestyle on the association between adverse childhood experiences and multimorbidity

doi: 10.16462/j.cnki.zhjbkz.2025.08.017

FENG Hongman^{1, 4},
XU Xianghui²,
LIU Mingyue^{1, 3},
CHEN Xinyang^{1, 3},
LI Xiaoming^{1, 3
,
,}

1.
Department of Preventive Medicine, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
2.
Department of Internal Medicine, North China University of Science and Technology Hospital, Tangshan 063210, China
3.
Hebei Key Laboratory of Occupational Health and Safety for Coal Industry, Tangshan 063210, China
4.
Department of Epidemiology and Biostatistics, School of Public Health Xi′an Jiaotong University, Xi′an 710061, China

Funds:

National Key Research and Development Program of China 2016YFC0900605

STI2030-Major Projects 2021ZD0200700

Science Research Project of Hebei Education Department QN2019190

Science and Technology Research Project of Tangshan City 22130234H

More Information

Corresponding author: LI Xiaoming, E-mail: lxmxxh@163.com
Received Date: 2024-10-25
Rev Recd Date: 2025-04-29
Publish Date: 2025-08-10

Abstract

Abstract

Objective This study aimed to examine the association between adverse childhood experiences (ACEs) and multimorbidity in middle-aged and older adults, and to investigate whether unhealthy lifestyle mediates this relationship. Methods We analyzed data from 7 513 participants aged ≥45 years in the China Health and Retirement Longitudinal Study from 2011 to 2018. Demographic characteristics, ACEs exposure, unhealthy lifestyle behaviors and chronic disease diagnoses were assessed. Group differences in multimorbidity prevalence were evaluated using t-tests or χ² tests. Unconditional logistic regression models quantified the effects of ACEs and lifestyle on multimorbidity. Mediation analysis was conducted using the Bootstrap method. Results The prevalence of multimorbidity among the 7 513 participants was 36.34% (95% CI: 35.25%-37.44%). Multivariate analysis revealed that each additional ACE was associated with an 10.4% increase in the risk of multimorbidity (95% CI: 1.058-1.152). Compared to individuals with one ACE, those with 3 and ≥4 ACEs had 38.3% (95% CI: 1.023-1.870) and 43.2% (95% CI: 1.065-1.926) higher risks of multimorbidity, respectively. Additionally, each additional unhealthy lifestyle behavior increased multimorbidity risk by 14.4% (95% CI: 1.077-1.216). Compared to those with healthy lifestyles, individuals with ≥4 unhealthy behaviors had a 99.1% higher risk (95% CI: 1.365-2.903). Mediation analysis revealed that unhealthy lifestyle did not have a significant mediating effect on multimorbidity in middle-aged and older adults (all P>0.05) Conclusions ACEs were positively correlated with multimorbidity, no significant mediating role of an unhealthy lifestyle was found between ACEs and multimorbidity among middle-aged and older adults.
- Adverse childhood experiences,
- Unhealthy lifestyle,
- Multimorbidity,
- Middle-aged and elderly individuals,
- Mediating effect

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References(16)

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