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PUBLIC RELEASE DATE:
7-Dec-2009

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Contact: Karl Leif Bates
karl.bates@duke.edu
919-681-8054
The JAMA Network Journals
@JAMA_current

Difficult childhood may increase disease risk in adulthood

Individuals who experience psychological or social adversity in childhood may have lasting emotional, immune and metabolic abnormalities that help explain why they develop more age-related diseases in adulthood, according to a report in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

As the population ages, age-related conditions such as heart disease, type 2 diabetes and dementia are becoming more prevalent, according to background information in the article. New ways of preventing these diseases and enhancing the quality of longer lives are needed. "Interventions targeting modifiable risk factors (e.g., smoking, inactivity and poor diet) in adult life have only limited efficacy in preventing age-related disease," the authors write. "Because of the increasing recognition that preventable risk exposures in early life may contribute to pathophysiological processes leading to age-related disease, the science of aging has turned to a life-course perspective."

Andrea Danese, M.D., M.Sc., of King's College London, England, and colleagues studied 1,037 members of the Dunedin Multidisciplinary Health and Development Study, a long-term investigation of individuals born in New Zealand between April 1972 and March 1973. During the first 10 years of life, participants were assessed for exposure to three adverse experiences: socioeconomic disadvantage, maltreatment and social isolation. At age 32, they were evaluated for the presence of three risks for age-related diseases: depression, high inflammation levels (measured by the blood marker C-reactive protein) and the clustering of metabolic risk factors, including high blood pressure, abnormal cholesterol levels and being overweight.

Individuals who had experienced adverse events as children were at higher risk of developing depression, high inflammation levels and the clustering of metabolic risk factors at age 32. The researchers estimate that 31.6 percent of the cases of depression, 13 percent of the cases of elevated inflammation and 32.2 percent of cases with clustered metabolic risk factors could be attributed to adverse childhood experiences.

"The effects of adverse childhood experiences on age-related disease risks in adulthood were non-redundant, cumulative and independent of the influence of established developmental and concurrent risk factors," such as family history, low birth weight or high childhood body mass index, the authors write.

"In conclusion, it has long been known that pathophysiological processes leading to age-related diseases may already be under way in childhood," they continue. "The promotion of healthy psychosocial experiences for children is a necessary and potentially cost-effective target for the prevention of age-related disease."

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(Arch Pediatr Adolesc Med. 2009;163[12]:1135-1143. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.



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