Adverse Childhood Experiences and the Co‐occurrence of Poor Oral Health and Multimorbidity: Findings From the Canadian Longitudinal Study on Aging

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Abstract
Objectives: To investigate the extent of the association of adverse childhood experiences (ACEs) with co‐occurring poor self‐reported oral health (SROH) and multimorbidity in middle‐aged and older adults, and whether these associations differ by age and sex.Methods: This cross‐sectional study used data from 27 765 adults aged 45–85 years from the first follow‐up wave (2015–2018) of the Canadian Longitudinal Study on Aging (CLSA). Four categories were generated to assess co‐occurring SROH and multimorbidity: (i) good SROH, no multimorbidity; (ii) poor SROH, no multimorbidity; (iii) good SROH, multimorbidity and (iv) poor SROH and multimorbidity. Age‐and sex‐stratified multinomial logistic regressions were used to examine associations of ACEs (e.g. childhood maltreatment, neglect, parental death, serious illness or separation) with co‐occurring poor SROH and multimorbidity, adjusted for the confounders race/ethnicity, income, level of education, smoking status and alcohol consumption.Results: Over a third of participants reported having multimorbidity (35.3%), 10.4% reported poor SROH, and almost 30% of participants had experienced at least one ACE. There was a gradient in the association between higher ACEs and each of the health outcome categories, with the greater odds being for the co‐occurrence of poor SROH and multimorbidity (OR = 1.37, 95% CI: 1.30, 1.44). The associations between ACEs and adverse health outcomes in later life were significant across age groups and sexes, with middle‐aged females demonstrating the strongest associations.Conclusions: ACEs are linked to an increased non‐communicable chronic disease burden and poor oral health among middle‐aged and older Canadians, highlighting the importance of prevention in early life and the focus on psychosocial factors over the life course for healthy aging.
Funding Information
  • Canadian Institutes of Health Research

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