Association of adverse childhood experiences with anemia in older Chinese: Guangzhou Biobank Cohort Study

Abstract

To examine the association of adverse childhood experiences (ACEs) with anemia among older people. 24,116 participants aged 50 years or above were recruited. Multivariable linear and logistic regression was used to assess the associations of self-reported ACEs number with hemoglobin concentrations (g/dL) and presence of anemia. Older individuals with two or more ACEs, versus no ACEs, showed lower hemoglobin concentrations (β = - 0.08 g/dL, 95% confidence intervals (CI) - 0.12 to - 0.03) and higher odds of anemia (odds ratio = 1.26, 95% CI 1.01-1.59). A more pronounced association between ACEs and anemia in the lower education group was found, while the association became non-significant in those with higher education (P for ACEs-education interaction = 0.02). ACEs was associated with anemia in older people, and the association was stronger in those with lower education, highlighting the significance of early-life psychological stressors assessment and consideration of education background in geriatric care.

Figure 1

Directed acyclic graph (DAG) of factors associated with anemia in Guangzhou Biobank Cohort Study. ACEs adverse childhood experiences; BMI body mass index. Note Green lines indicated causal paths. Pink lines indicated biasing paths. Pink dots were potential confounders which were ancestors of exposure and outcome. Blue dots were latent mediators.

Figure 2

Association of ACEs (Yes vs. No) with anemia by demographic characteristics and socioeconomic status in Guangzhou Biobank Cohort Study. OR odds ratio; CI confidence interval, ACEs adverse childhood experiences. Note This model adjusted for sex, age, education status and childhood socioeconomic status.