Objectives: This study aims to establish the effects of ACEs on multimorbidity through sleep quality and investigate whether lifestyle factors (e.g., eating habits and exercise) may influence this relationship among middle-aged and older adults.
Methods: Participants were drawn from a cross-sectional sample of community dwelling older adults (N = 276, 55+) and three waves of data from the Midlife in the United States study (MIDUS, N = 843). We examined the direct and indirect effects of ACEs, sleep quality, and health conditions, as well as the conditional effects of physical activity and eating habits.
Results: Across both samples, sleep quality mediated the relationship between ACEs and chronic health conditions. Moderating effects of unhealthy eating and physical activity differed between samples.
Discussion: Sleep quality is an important pathway connecting ACEs and adult multimorbidity, and health behaviors may provide targets for intervention particularly in older adults.
Keywords: adverse childhood experiences; health behaviors; lifestyle; multimorbidity; nutrition; older adults; physical activity; sleep.