Roles of participation in social activities in the association between adverse childhood experiences and health among older Japanese adults

Marisa Nishio; Michael Green; Naoki Kondo

doi:10.1016/j.ssmph.2021.101000

Roles of participation in social activities in the association between adverse childhood experiences and health among older Japanese adults

SSM Popul Health. 2021 Dec 14:17:101000. doi: 10.1016/j.ssmph.2021.101000. eCollection 2022 Mar.

Authors

Marisa Nishio¹, Michael Green², Naoki Kondo³

Affiliations

¹ School of Social & Political Sciences, University of Glasgow, Glasgow G12 8QQ, Scotland, UK.
² MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, Scotland, UK.
³ Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Floor 2, Science Frontier Laboratory, Yoshida-konoe-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8315, Japan.

Abstract

Adverse childhood experiences (ACEs) have shown strong associations with later-life health such as depression and subjective health. Social participation is also associated with later-life health but it is unclear to what extent this could contribute to alleviating harmful impacts of ACEs, nor is it clear whether ACEs are themselves associated with later-life social participation. Thus, this study aims to understand: (1) the influence of ACEs on social participation in later life and (2) whether social participation can alleviate the harmful influences of ACEs on depression and subjective health among Japanese older adults. Data were from 5,671 Japanese older adults (aged 65+) in surveys in 2013 and 2016 as part of the Japan Gerontological Evaluation Study (JAGES). Logistic regression analyses were conducted to estimate the relations between ACEs and later-life social participation, adjusting for potential confounders and mediators. Inverse probability weighting was used to estimate average effects of ACEs on later-depression and subjective health, adjusting for potential confounders, and these were compared against controlled direct effect (CDE) estimates from marginal structural models based on all respondents experiencing weekly social participation. We found that ACEs were associated with reduced later-life social participation (OR for >1 ACEs = 0.88, 95% CI = 0.79, 0.99). The estimated effect of ACEs on depression ( adjusted total effect estimates: OR = 1.23, 95% CI = 1.05, 1.45) was marginally alleviated in estimates assuming weekly social participation for everyone (CDE = 1.18, 95% CI = 0.98, 1.43). A similar tendency was seen for poor subjective heath. Negative impacts of ACEs on depression may be marginally mitigated through social participation, but mitigating effects were moderate. Further investigation on other potential later-life mitigating factors is needed.

Keywords: Adverse childhood experience; Controlled direct effect; Depression; Older adults; Social participation; Subjective health.

Abstract

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