童年逆境与中老年人社会隔离关联的时变效应分析  

Time-varying associations between adverse childhood experiences and social isolation in middle-aged and older adults

作　　者：辜自洁 张晴晴 季小艺 宋林阳 邱培媛 万洋 GU Zi-jie;ZHANG Qing-qing;JI Xiao-yi;SONG Lin-yang;QIU Pei-yuan;WAN Yang(West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sicuan 610041,China)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院,四川成都610041

出　　处：《现代预防医学》2025年第4期667-672,共6页Modern Preventive Medicine

基　　金：国家自然科学基金项目(72174133)。

摘　　要：目的探索童年逆境与中老年人社会隔离关联的年龄效应,为早期发现社会隔离的高危人群,制定合适的干预措施提供科学依据。方法研究对象为参加了CHARLS 2014年中国居民生命历程调查,且至少参加了一次2011、2013、2015、2018和2020年调查的受访者。童年逆境通过自我报告的方式收集,根据经历童年逆境的数量划分为四组:未经历童年逆境组、经历一种童年逆境组、经历两种童年逆境组和经历三种及以上童年逆境组。采用时变效应模型,以年龄作为时间变量,探索童年逆境与中老年人社会隔离关联的年龄效应。结果研究共纳入14397名研究对象,与未经历童年逆境的中老年人相比,经历一种童年逆境的中老年人在61岁至70岁时发生社会隔离的风险增高(OR=1.22,95%CI:1.06~1.41);经历两种童年逆境的中老年人在50至65岁时发生社会隔离的风险增高(OR=1.33,95%CI:1.13~1.57);经历三种及以上童年逆境的中老年人在45岁至58岁时发生社会隔离的风险增高(OR=1.86,95%CI:1.16~2.99)。结论童年逆境与中老年人社会隔离的关联存在年龄效应,经历的童年期逆境越多,发生社会隔离的年龄越小。Objective To explore the time-varying association between adverse childhood experiences and social isolation in middle-aged and older adults and provide a scientific evidence for the early identification of people at risk of social isolation and the development of appropriate interventions.Methods Data were used from respondents who participated in the life history survey of the China Health and Retirement Longitudinal Study(CHARLS)and at least one of the surveysconducted between 2011 and 2020.Adverse childhood experienceswere collected through self-reporting and divided into four groups based on the number of adverse childhood experiences,which were categorized into the group that had not experienced adverse childhood experiences,the group that had experienced one type of adverse childhood experience,the group that had experienced two types of adverse childhood experiences,and the group that had experienced three or more types of adverse childhood experiences.A time-varying effect model was used to explore the age-varying association between adverse childhood experiences and social isolation among middle-aged and older adults,using age as the time variable.Results A total of 14397 middle-aged and older adults were included in the study.Compared with those who had not experienced adverse childhood experiences,those who had experienced one adverse childhood experience had a higher risk of social isolation between the ages of 61 and 70(OR=1.22,95%CI:1.06-1.41);those who had experienced two adverse childhood experiences had a higher risk of social isolation between the ages of 50 and 65(OR=1.33,95%CI:1.13-1.57);and those who had experienced three or more adverse childhood experiences had a higher risk of social isolation between the ages of 45 and 58(OR=1.86,95%CI:1.16-2.99).Conclusion There is aage-varyingassociation between adverse childhood experiences and social isolation among middle-aged and elderly people,with the more childhood adversities experienced,the younger the age at which social isolation occurs.

关 键 词：童年逆境 社会隔离 时变效应模型 

分 类 号：R195.4[医药卫生—卫生统计学]