Adverse childhood experiences and adulthood physical performance: the <i>Brazilian Longitudinal Study of Adult Health</i> (ELSA-Brasil)

Pinto, Rodrigo; Barreto, Sandhi Maria; Machado, Amanda Viana; Patrão, Ana Luísa; Giatti, Luana; Griep, Rosane Harter; Telles, Rosa Weiss; Camelo, Lidyane do Valle

doi:10.1590/0102-311XEN039125

person Rodrigo Pinto

study conception and design · data analysis and interpretation · writing, and critical review · approved the final version

school Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

0000-0002-2778-9991

person Sandhi Maria Barreto

study conception and design · data analysis and interpretation · critical review · approved the final version

school Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

0000-0001-7383-7811

person Amanda Viana Machado

data analysis and interpretation · critical review · approved the final version

school Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

0000-0001-5879-9466

person Ana Luísa Patrão

critical review · approved the final version

school Universidade do Porto, Porto, Portugal.

0000-0002-2027-5461

person Luana Giatti

data interpretation and critical review · approved the final version

school Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

0000-0001-5454-2460

person Rosane Harter Griep

data interpretation and critical review · approved the final version

school Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.

0000-0002-6250-2036

person Rosa Weiss Telles

study conception and design · data analysis and interpretation · writing, and critical review · approved the final version

school Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

0000-0003-4027-2943

person Lidyane do Valle Camelo

study conception and design · data analysis and interpretation · writing, and critical review · approved the final version

school Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

0000-0001-7471-7547

personCorrespondence L. V. Camelo Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Belo Horizonte, MG 30130-100, Brasil.
lidyanecamelo@gmail.com

Associate Editor

Evaluation coordinator: Priscila Maria Stolses Bergamo Francisco (0000-0001-7361-9961)

Conflict of interests

None to declare.

Variables	Total	Physical performance
	Total	Poor (≤ 7 points)	Good (≥ 8 points)
	n (%)	n = 3,048 (%)	n = 7,848 (%)
Sociodemographic parameters
Sex
Male	4,897 (44.9)	1,103 (22.5)	3,794 (77.5)
Female	5,999 (55.1)	1,945 (32.4)	4,054 (67.6)
Age group (years)
41-50	1,771 (16.3)	310 (17.5)	1,461 (82.5)
51-60	4,595 (42.1)	1,055 (23.0)	3,540 (77.0)
61-70	3,299 (30.3)	1,076 (32.6)	2,223 (67.4)
71 or more	1,231 (11.3)	607 (49.3)	624 (50.7)
Race/Skin color *
White **	6,296 (58.4)	1,591 (25.3)	4,705 (74.7)
Brown	2,850 (26.4)	808 (28.3)	2,042 (71.7)
Black ***	1,635 (15.2)	609 (37.2)	1,026 (62.8)
Childhood socioeconomic position
Maternal education *
High school or higher	2,686 (25.0)	569 (21.2)	2,117 (78.8)
Elementary education	2,066 (19.2)	577 (27.9)	1,489 (72.1)
Primary education	4,621 (43.0)	1,281 (27.7)	3,340 (72.3)
Had not attended school	1,371 (12.8)	553 (40.3)	818 (59.7)
Paternal education *
High school or higher	3,409 (31.3)	796 (23.3)	2,613 (76.7)
Elementary education	2,051 (18.8)	551 (26.9)	1,500 (73.1)
Primary education	4,074 (37.4)	1,142 (28.0)	2,932 (72.0)
Had not attended school	881 (4.4)	361 (41.0)	520 (59.0)
ACEs
Child labor
No	10,168 (93.3)	2,788 (27.4)	7,380 (72.6)
Yes	728 (6.7)	260 (35.7)	468 (64.3)
Having lived with household members who were problem drinkers, had alcohol disorder or misused street or prescription drugs
No	8,638 (79.3)	2,396 (27.7)	6,242 (72.3)
Yes	2,258 (20.7)	652 (28.9)	1,606 (71.1)
Having lived with household members who were depressed, mentally ill, or suicidal
No	9,927 (91.1)	2,777 (27.0)	7,150 (72.0)
Yes	969 (8.9)	271 (27.0)	698 (72.0)
Having lived with household members who were sent to jail or prison
No	10,714 (98.3)	2,986 (27.9)	7,728 (72.1)
Yes	182 (1.7)	62 (34.1)	120 (65.9)
Parental separation/divorce
No	9,596 (88.1)	2,650 (27.6)	6,946 (72.4)
Yes	1,300 (11.9)	398 (30.6)	902 (69.4)
Death of parents or guardians
No	9,717 (89.2)	2,649 (27.3)	7,068 (72.7)
Yes	1,179 (10.8)	399 (33.8)	780 (66.2)

Variables	Total	ACEs
	Total	Exposed *	Not exposed
	n (%)	n = 4,596 (%)	n = 6,300 (%)
Sociodemographic variables
Sex
Male	4,897 (44.9)	1,972 (40.3)	2,925 (59.7)
Female	5,999 (55.1)	2.624 (43,7)	3,375 (56.3)
Age group (years)
41-50	1,771 (16.3)	830 (46.9)	941 (53.1)
51-60	4,595 (42.1)	2,065 (44.9)	2,530 (55.1)
61-70	3,299 (30.3)	1,313 (39.8)	1,986 (60.2)
71 or more	1,231 (11.3)	388 (31.5)	843 (68.5)
Race/Skin color **
White ***	6,296 (58.4)	2,240 (35.6)	4,056 (64.4)
Mixed-race	2,850 (26.4)	1,387 (48.7)	1,463 (51.3)
Black ^#	1,635 (15.2)	929 (56.8)	706 (43.2)
Childhood socioeconomic position
Maternal education *
High school or higher	2,686 (25.0)	937 (34.9)	1,749 (65.1)
Elementary education	2,066 (19.2)	829 (40.1)	1,237 (59.9)
Primary education	4,621 (43.0)	1,981 (42.9)	2,640 (57.1)
Had not attended school	1,371 (12.8)	741 (54.1)	630 (45.9)
Paternal education *
High school or higher	3,409 (31.3)	1,125 (33.0)	2,284 (67.0)
Elementary education	2,051 (18.8)	839 (40.9)	1,212 (59.1)
Primary education	4,074 (37.4)	1,773 (43.5)	2,301 (56.5)
Had not attended school	881 (4.4)	497 (56.4)	384 (43.6)

	Child labor	Having lived with household members who were problem drinkers, had alcohol disorder or misused street or prescription drugs	Having lived with household members who were depressed, mentally ill, or suicidal	Having lived with household members who were sent to jail or prison	Parental separation/divorce	Death of parents or guardians
Child labor	1.000
Having lived with household members who had drinking and alcohol disorder or misused street or prescription drugs	0.291 *	1.000
Having lived with household members who were depressed, mentally ill or suicidal	0.115 *	0.331 *	1.000
Having lived with household members who were sent to jail or prison	0.190 *	0.370 *	0.269 *	1.000
Parental separation/divorce	0.217 *	0.261 *	0.180 *	0.211 *	1.000
Death of parents or guardians	0.226 *	0.120 *	0.070 **	0.151 *	0.085 *	1.000

Variables	Crude model	Model 1	Model 2	Final model
OR (95%CI)	OR (95%CI)	OR (95%CI)	OR (95%CI)
ACEs cumulative score
No exposure	Reference	Reference	Reference	Reference
Exposure to one type	1.20 (1.09; 1.32) *	1.30 (1.18; 1.43) *	1.23 (1.11; 1.36) *	1.18 (1.07; 1.32) **
Exposure to two types	1.27 (1.10; 1.45) **	1.40 (1.22; 1.62) *	1.29 (1.11; 1.49) **	1.19 (1.02; 1.39) ***
Exposure to three or more types	1.37 (1.10; 1.70) **	1.66 (1.32; 2.08) *	1.44 (1.15; 1.81) **	1.36 (1.05; 1.75) ***
Child labor
No	Reference	Reference	Reference	Reference
Yes	1.47 (1.26; 1.72) *	1.55 (1.31; 1.82) *	1.36 (1.15; 1.61) *	1.19 (0.99; 1.43)
Having lived with household members who were problem drinkers, had alcohol disorder or misused street or prescription drugs
No	Reference	Reference	Reference	Reference
Yes	1.06 (0.95; 1.17)	1.22 (1.09; 1.35) *	1.14 (1.02; 1.27) ***	1.10 (0.98; 1.23)
Having lived with household members who were depressed, mentally ill, or suicidal
No	Reference	Reference	Reference	Reference
Yes	1.00 (0.86; 1.16)	1.01 (0.87; 1.18)	1.03 (0.89; 1.20)	1.05 (0.90; 1.23)
Having lived with household members who were sent to jail or prison
No	Reference	Reference	Reference	Reference
Yes	1.34 (0.98; 1.82)	1.45 (1.05; 2.00) ***	1.37 (0.99; 1.89)	1.43 (1.02; 1.99) ***
Parental separation/divorce
No	Reference	Reference	Reference	Reference
Yes	1.16 (1.02; 1.31) ***	1.35 (1.18; 1.54) *	1.24 (1.08; 1.41) **	1.17 (1.01; 1.36) ***
Death of parents or guardians
No	Reference	Reference	Reference	Reference
Yes	1.36 (1.20; 1.55) *	1.32 (1.15; 1.51) *	1.23 (1.07; 1.40) **	1.22 (1.05; 1.41) ***

[TFN1] * Race/Skin color has 115 missing individuals; maternal education 152 missing individuals; paternal education 481 missing individuals;

[TFN2] ** White individuals (n = 6,000) were analyzed together with individuals with Asian origins (n = 296);

[TFN3] *** Black individuals (n = 1,534) were analyzed together with Brazilian Indigenous individuals (n = 101).

Adverse childhood experiences and adulthood physical performance: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Experiências adversas na infância e desempenho físico na vida adulta: Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)

Experiencias adversas en la infancia y desempeño físico en la edad adulta: el Estudio Longitudinal de Salud del Adulto (ELSA-Brasil)

Abstract