Adverse childhood experiences and trajectories of hearing, vision, and dual sensory loss among middle-aged and older adults: three population-based longitudinal studies in China

OBJECTIVES: Guided by life-course theory, this study examined the associations between adverse childhood experiences (ACEs) and later-life trajectories of sensory loss among Chinese adults. METHODS: Three separate studies utilized data from the China Health and Retirement Longitudinal Study (CHARLS). The trajectories of self-reported hearing loss (HL), vision loss (VL), and dual sensory loss (DSL) were identified by latent class growth analysis. Latent class analysis-classified ACEs patterns. Binary and multinomial logistic regressions assessed associations between ACEs and sensory trajectories, and network analysis identified central ACE nodes. RESULTS: Greater exposure to cumulative, threat-related, and deprivation-related ACEs was associated with poorer HL, VL, and DSL trajectories. Participants in ACE Class 1 "Parental loss & household mental illness" had higher risks of persistently poor HL (RRR = 1.86 [95% CI: 1.41-2.46]), fair HL (RRR = 1.25 [1.01-1.53]), and poor DSL (OR = 1.30 [1.07-1.57]). Those in Class 2 "Physical abuse with bullying and neglect" showed increased risks of poor HL and DSL (RRR/OR = 1.31-1.44), whereas Class 3 "Parental loss & household mental illness" was associated only with poor or fair VL. Network analysis highlighted physical abuse and household violence as the most central nodes. DISCUSSION: These findings highlight the importance of ACEs for later-life sensory health, suggesting that addressing specific experiences, especially physical abuse and household violence, may strengthen prevention efforts.