Witnessing Interparental Violence in Childhood and Frailty in Adulthood: Evidence From a National Population-Based Study in China

OBJECTIVES: This study examines the relationship between witnessing parental violence-a specific type of adverse childhood experiences (ACEs)-and frailty in adulthood, employing a graded exposure measurement approach. DESIGN: A population-based cross-sectional study. SETTING AND PARTICIPANTS: Data from 6490 adults aged ≥45 years from the 2014 wave of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Frailty was assessed using the Frailty Index (FI). Exposure was measured by 3 items and categorized into low, medium, and high levels. METHODS: Linear and logistic regression models were employed to examine the associations between exposure and continuous FI scores, as well as frailty risk (FI ≥ 0.25), respectively. All models were adjusted for age, gender, marital status, rural/urban residence, education, smoking, alcohol use, and body mass index. Dose-response relationships were further evaluated using restricted cubic spline (RCS) models, with optimal knot selection to improve model fit. RESULTS: Higher exposure scores were significantly associated with increased FI (β = 0.004, P < .001) and frailty risk (odds ratio, 1.08; 95% CI, 1.04-1.12). RCS models revealed a monotonic increase in frailty with greater exposure. CONCLUSIONS AND IMPLICATIONS: Witnessing interparental violence in childhood is significantly linked to higher frailty in adulthood. Interventions addressing domestic violence may contribute to healthier aging outcomes.