We often use the term “age-related disease.” What that refers to are diseases that one would expect to see as population ages. The diseases that fall in this category would include cardiovascular disease, type 2 diabetes and even dementia. We know that there are a whole host of modifiable factors that can increase your chances of ageing in a healthy way. For example, smoking, inactivity, poor diets and limiting alcohol can increase your likelihood of staying healthy.
But what about the exposures that happen in early childhood — and more importantly, the preventable risk exposures? Are there exposures that we could eliminate that would translate into healthier adults, and therefore, a healthier aging population?
In this week’s Archives of Paediatric and Adolescent Medicine is a study that tracked children for 32 years and tried to understand if early preventable exposures would translate into adverse outcomes.
A total of 1,037 volunteers were followed and at age 32, they were assessed. The types of exposures that were looked at were:
- socioeconomic disadvantage
- maltreatment (maternal rejection, harsh discipline, physical/sexual abuse, caregiver change)
- social isolation (tends to do things on their own, not liked by other children)
At age 32, the group were studied for three age-related disease risks:
- high inflammation levels (C Reactive Protein – CRP)
- metabolic risk biomarkers: overweight, high BP, high total cholesterol, low HDL, high glycated haemoglobin (a diabetes marker) and low maximum O2 consumption levels
We know, for example, that depression can be linked to increased risk of diabetes, cardiovascular disease and dementia in later life. Inflammation contributes to atherosclerosis, insulin resistance and degeneration of the nervous system (neurodegeneration). High CRP can predict their risk of development of the same kind of later-onset diseases mentioned above. And finally, metabolic biomarkers are also associated with a greater risk of disease development in later life. It has been thought that traumatic or adverse childhood experiences can impact on the physiology and its response to stress and lead to all three outcomes studied.
The results were quite fascinating. Group by group, once other possible causes were controlled for, it was found that:
- 32% of depression was due to adverse childhood experiences
- 13% of elevated inflammation was due to adverse childhood experiences
- 32% of clustered metabolic risk factors were due to adverse childhood experiences
The researchers found that family history, low birth weight and high childhood BMI predicted a greater number of age-related disease risks at age 32. That makes sense.
As the severity of childhood socioeconomic disadvantage, maltreatment and social isolation increased, the number of age-related disease risks also increased in a dose-response fashion. And the researchers note that even when you take into account the established risk factors that could not be controlled and risk factors at age 32 (like current smoking, poor diet and physical inactivity) each adverse childhood experience STILL predicted a number of age-related disease risks at that age. What is also fascinating is that the exposure to different adverse experiences does not necessarily overlap. For example, most of the children who had maltreatment or social isolation did not have a socioeconomic disadvantage. As well, the researchers noted that children exposed to a greater number of adverse experiences have a greater number of age-related disease risks in adult life.
The researchers believe that adverse psychosocial experiences as a child can disrupt the way in which the body responds to stress-sensitive systems and that would have an impact on the immune system, the nervous system and the endocrine system and that would then translate into age-related disease risks. What was also found was that children exposed to these adverse events are also more likely to have age-related disease risk factors regardless of their family history of diseases and health behaviours. That would suggest that while it is important to modify known existing risk factors, it is crucial to promote healthy psychosocial experiences for our children.
I found this study fascinating. While we know about the mind-body link, this is a study that examines adverse childhood experiences and links it to disease in later life. While it is critical we teach our children the importance of a healthy diet and lifestyle, no smoking and alcohol in moderation when appropriate, it also reinforces the critical importance of providing healthy psychosocial environments for our children to help translate into healthier adults, both mentally and physically.