Adverse childhood experiences (ACE) are important for chronic diseases yet their association with multimorbidity remains understudied. Few studies consider the complexity of multimorbidity or observe multimorbidity development over time.
We investigated whether ACE were associated with multimorbidity at baseline and over a 12-year follow-up period.
5326 participants aged over 50 were obtained from the English Longitudinal Study of Ageing (ELSA).
An ACE summary score was derived using eight ACE items measuring abuse, social care, and household dysfunction. From repeated measurements of 29 chronic conditions over a 12-year period (2008-2019) we derived two multimorbidity measures: number of chronic diseases and number of chronic disease categories. We used multinomial logistic regression to assess associations between ACE and both measures. Mixed effects models were estimated to examine trajectories of multimorbidity by ACE over time.
Graded associations between ACE and multimorbidity were observed. Compared to those without ACE, participants with ≥3 ACE had three times the risk of having ≥3 chronic diseases (RRR 3.06, 95 % CI 1.85-5.05) and falling into ≥3 chronic disease categories (RRR 2·93 95 % CI 1·74-4·95). Graded associations persisted during 12-year follow-up, though differences in multimorbidity between those with ≥3 ACE and those without ACE remained constant (B 0.02, 95 % CI 0·01-0·03, and B -0·01, 95 % CI -0·02-0·00, number of chronic conditions and chronic condition categories respectively).
ACE are associated with multimorbidity risk and complexity, associations arising before the age of 50. Early intervention amongst those with ACE could attenuate this association.

Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses. The relationship with birthweight (BW), however, is conflicting. We examined associations of self-reported BW with lung function and the development of respiratory and also non-respiratory diseases within the GEIRD (Gene-Environment Interaction in Respiratory Diseases) project, an Italian multi-centre, multi-case control study involving cases of COPD, asthma, allergic rhinitis and controls. Multinomial logistic regression was performed with case/control status as response variable; BW as main determinant; and adjusting for sex, age and smoking status. Of the 2287 participants reporting BW, 6.4% (n = 147) had low BW (<2500 g), and this proportion was greater in women than men (7.8% vs. 5.1%; p = 0.006). Both men and women with low BW were shorter than those with normal BW (mean ± SD: 160.2 ± 5.5 vs. 162.6 ± 6.5 cm in women, p = 0.009; 172.4 ± 6.1 vs. 174.8 ± 7.2 cm in men, p < 0.001). Although FEV1 and FVC were reduced in individuals with low BW, this was explained by associations with sex and height. In multivariable analysis, BW was not associated with respiratory diseases in adulthood. However, those with low BW had a higher risk of self-reported hospitalisation for lung disease before the age of two (10.3% vs. 4.1%; p < 0.001), severe respiratory infection before the age of five (16.9% vs. 8.8%; p = 0.001) and hypertension in adulthood (29.9% vs. 23.7%; p = 0.001); however, they had a lower risk of arrhythmia (2.7% vs. 5.8%; p = 0.027).

UNASSIGNED: Various domains of psychosocial stress have been significantly related to blood pressure. However, ambiguity is present in how these relationships are defined in the literature.
UNASSIGNED: To add to the existing literature and examine the relationship between psychosocial stress (financial strain and job strain) and other cofactors on blood pressure.
UNASSIGNED: This secondary analysis is designed to analyze the relationship between levels of job and financial stress and blood pressure outcomes among participants in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study 2004-2008. The descriptive, cross-sectional design uses data from a subset of study participants, 350 White and 195 Black (n = 545), 338 female (62%), and all aged 18-56 years. Psychosocial stress was measured using the Singh Stress Scale. Resting systolic (SBP) and diastolic (DBP) blood pressure values obtained on a stress reactivity protocol day in the primary study, as well as calculated mean arterial pressure (MAP) were used for this analysis. Multivariate linear regression analyses were used to explore the relationship between psychosocial stress and blood pressure.
UNASSIGNED: In this young cohort, self-report of either financial strain or job strain was associated with lower blood pressure levels than those of participants who reported neither stressor. Differential sex and race effects appear to contribute to these results. Blood pressure levels were not significantly associated with self-report of both stressors.
UNASSIGNED: Understanding the effects of various forms of stress on blood pressure may inform more precise HTN risk-factor screening and interventions to improve BP management.

This paper uses longitudinal survey data linked to administrative registers to examine socioeconomic gradients in health, particularly whether the effects of genetic endowments interact with the socioeconomic resources of the parental household. We find that genetic risk scores contribute to adult health measured by biomarkers. This result is consistent with the findings from genome-wide association studies. Socioeconomic gradients in health differ based on biomarker and resource measures. Family education is negatively related to obesity and the waist-hip ratio, and family income is negatively related to low-density lipoprotein cholesterol and triglyceride levels. Parental resources do not modify the effects of genetic endowment on adult health. However, there is evidence for gene-family income interactions for triglyceride levels, particularly among women.

BACKGROUND: Population ageing has become significant in South African society, increasing the need to improve understandings of health and well-being among the aged.
OBJECTIVE: To describe the self-reported ratings of overall health and functioning, and to identify factors associated with self-rated health among older South Africans.
METHODS: A national population-based cross-sectional survey, with a sample of 3,840 individuals aged 50 years and older, was completed in South Africa in 2008. Self-reported ratings of overall health and functioning were measured using a single self-reported health state covering nine health domains (used to generate the Study on Global Ageing and Adult Health (SAGE) composite health state score). Disability was measured using the World Health Organization Disability Assessment Schedule II (WHODAS-II) activities of daily living (ADLs), instrumental activities of daily living (IADLs), perceptions of well-being, and the World Health Organization Quality of Life index/metric (WHOQoL).
RESULTS: Overall, more than three quarters (76.8%) of adults rated their health as moderate or good. On balance, men reported very good or good health more often than women (p<0.001). Older people (aged 70 years and above) reported significantly poorer health status than those aged 50-59 (adjusted odds ratio (AOR) 1.52; 95% confidence interval (CI) 1.00-2.30). Indians and Blacks were significantly more likely to report poorer health status at (AOR = 4.01; 95% CI 1.27-12.70) and (AOR = 0.42; 95% CI 0.18_0.98; 30 p < 0.045), respectively, compared to Whites. Respondents with primary education (AOR = 1.83; 95% CI 1.19-2.80) and less than primary education (AOR = 1.94; 95% CI 1.37-2.76) were more likely to report poorer health compared to those with secondary education. In terms of wealth status, those in low wealth quintile (AOR = 2.02; 95% CI 1.14-3.57) and medium wealth quintile (AOR = 1.47; 95% CI 1.01-2.13) were more likely to report poorer health status than those in high wealth quintile. Overall, the mean WHODAS-II score was 20%, suggesting a low level of disability. The mean WHOQoL score for females (Mean = 51.5; SD = 12.2) was comparable to that of males (Mean = 49.1; SD = 12.6).
CONCLUSIONS: The depreciation in health and daily functioning with increasing age is likely to increase demand for health care and other services as people grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect, and promote the health and well-being of older people.

It has been known that outdoor temperature influences seasonal fluctuation of blood pressure and cholesterol levels, but the role of indoor temperature has been less studied. Therefore, the aim of the present study was to examine the associations between indoor temperature and biomarkers in a countrywide and population-based setting. Data was retrieved from the English Longitudinal Study of Ageing, 2012-2013. Information on demographics, room temperature and a series of biomarkers measured in the blood and lung was obtained at household interviews. t test, chi-square test and a generalized linear model were performed cross-sectionally. Of 7997 older adults with the valid indoor temperature measurements, there were 1301 (16.3%) people who resided in cold homes (<18 °C). Age was inversely associated with people who resided in cold homes or who tended not to have blood pressure check-up. Those who resided in cold homes had higher blood pressure readings, worse handgrip, lower vitamin D levels, higher cholesterol levels, higher insulin-like growth factor levels, higher haemoglobin levels, lower level of white blood cell count and worse lung conditions. One in six older adults aged 50 and above in England resided in cold homes and had poor biomarker values. For the future research direction, studies with a longitudinal approach to systematically monitor indoor temperature, biomarkers and health and wellbeing would be suggested. From the practice and policy perspectives, increasing health knowledge on the adverse effect of low indoor temperature on risks of cardiac and respiratory conditions, affording to the heating and re-designing of residential buildings to keep warm by using efficient energy, should be kept as priority.