Citation

Archer G, Pinto Pereira S, Power C. BMJ Open 2017; 7(10): e017900.

Affiliation

Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.

Copyright

(Copyright © 2017, BMJ Publishing Group)

DOI

10.1136/bmjopen-2017-017900

PMID

29079607

Abstract

OBJECTIVE: Child maltreatment (abuse and neglect) has established associations with mental health; however, little is known about its relationship with physical functioning. Physical functioning (ie, the ability to perform the physical tasks of daily living) in adulthood is an important outcome to consider, as it is strongly associated with an individual's ability to work, and future disability and dependency. We aimed to establish whether maltreatment was associated with physical functioning, independent of other early-life factors. SETTING: 1958 British birth cohort. PARTICIPANTS: 8150 males and females with data on abuse and who participated at age 50 years. OUTCOME MEASURES: The primary outcome was poor physical functioning at 50 years (<65 on the Short-Form 36 survey physical functioning subscale). Secondary outcomes included mental health and self-reported health at 50 years.

RESULTS: 23% of participants reported at least one type of maltreatment; 12% were identified with poor physical functioning. Neglect (ORadj 1.55, 95% CI 1.24 to 1.93), psychological abuse (ORadj 1.49, 1.17-1.88) and sexual abuse (ORadj 2.56, 1.66-3.96) were associated with poor physical functioning independent of other maltreatments and covariates, including childhood social class, birth weight and childhood illness. Odds of poor physical functioning increased with multiple types of maltreatment (ptrend <0.001); ORadj ranged from 1.49 (1.23-1.82) for a single type to 2.09 (1.53-2.87) for those reporting > 3 types of maltreatment, compared with those with none. Associations of similar magnitude were observed for mental and self-reported health outcomes.

CONCLUSIONS: Child neglect, psychological and sexual abuse were associated with poor physical functioning at 50 years, with accumulating risk for those with multiple types of maltreatment. Associations were independent of numerous early-life factors and were comparable in magnitude to those observed for mental health and self-rated health. Prevention or alleviation of the ill effects of maltreatment could be an effective policy intervention to promote healthy ageing.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Language: en

Keywords

child abuse and neglect; disability; epidemiology; mental health; physical functioning