Restricted accessResearch articleFirst published online 2026
The association between adverse childhood experiences and successful aging among older people in China: Evidence from the China Health and Retirement Longitudinal Study (CHARLS)
The aim of current study was to assess the association between adverse childhood experiences (ACEs) and successful aging among Chinese. A total of 7517 participants from the China Health and Retirement Longitudinal Study 2011 were included in cross-sectional analyses. Any of 12 ACEs, measured by indicators on a questionnaire. Overall prevalence of successful aging was 11.77%, and there was an increase in number of ACEs was associated with a decreasing trend in the prevalence of successful aging, and those experiencing four or more ACEs had the lowest level of successful aging. Compared to participants without ACEs exposure, those experiencing three and four or more ACEs were associated with lower odds of achieving successful aging, with corresponding odds ratio (95% confidence interval) of 0.77 (0.60–0.98) and 0.63 (0.49–0.82), respectively. In conclusion, exposure to ACEs showed a lower likelihood of successful aging among the middle-aged and elderly people in China.
AbouelmagdMEAbdelMesehMElrosasyA, et al. (2025) Adverse childhood experiences and risk of late-life dementia: A systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology60: 1087–1098.
2.
AndaRFCroftJBFelittiVJ, et al. (1999) Adverse childhood experiences and smoking during adolescence and adulthood. Journal of the American Medical Association282(17): 1652–1658.
3.
Arias-MerinoEDMendoza-RuvalcabaNMArias-MerinoMJ, et al. (2012) Prevalence of successful aging in the elderly in western Mexico. Current Gerontology and Geriatrics Research2012: 460249.
4.
AshidaTFujiwaraTKondoK (2023) Association between adverse childhood experiences and social integration among older people in Japan: Results from the JAGES study. Archives of Gerontology and Geriatrics114: 105099.
5.
BeardJROfficerAde CarvalhoIA, et al. (2016) The World report on ageing and health: A policy framework for healthy ageing. Lancet387(10033): 2145–2154.
6.
BellisMAHughesKFordK, et al. (2019) Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: A systematic review and meta-analysis. Lancet Public Health4(10): e517–e528.
7.
BjörkenstamCKosidouKBjörkenstamE (2017) Childhood adversity and risk of suicide: Cohort study of 548 721 adolescents and young adults in Sweden. BMJ357: j1334.
8.
BjörkenstamEHjernAMittendorfer-RutzE, et al. (2013) Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and psychotropic medication in young adults. PLoS One8(1): e53551.
9.
ChangXJiangXMkandarwireT, et al. (2019) Associations between adverse childhood experiences and health outcomes in adults aged 18-59 years. PLoS One14(2): e0211850.
10.
ChenHFanQNicholasS, et al. (2022) The long arm of childhood: The prolonged influence of adverse childhood experiences on depression during middle and old age in China. Journal of Health Psychology27(10): 2373–2389.
11.
CopelandWEShanahanLHinesleyJ, et al. (2018) Association of Childhood Trauma Exposure with adult psychiatric disorders and functional outcomes. JAMA Network Open1(7): e184493.
12.
DempsterKSO’LearyDDMacNeilAJ, et al. (2021) Linking the hemodynamic consequences of adverse childhood experiences to an altered HPA axis and acute stress response. Brain, Behavior, and Immunity93: 254–263.
13.
FabioRANatoloLCaprìT, et al. (2025) Exploring the impact of adverse childhood experiences on health and cognitive functions in older adults. Journal of Health Psychology30(8): 1780–1794.
14.
FelittiVJAndaRFNordenbergD, et al. (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine14(4): 245–258.
15.
FinkelhorDShattuckATurnerH, et al. (2013) Improving the adverse childhood experiences study scale. JAMA Pediatrics167(1): 70–75.
16.
FurmanDCampisiJVerdinE, et al. (2019) Chronic inflammation in the etiology of disease across the life span. Natural Medicines25(12): 1822–1832.
17.
GilgoffRSinghLKoitaK, et al. (2020) Adverse childhood experiences, outcomes, and Interventions. Pediatric Clinics of North America67(2): 259–273.
18.
GuoPLiY (2022) Innovation and financial sustainability in China’s long-term care insurance: An empirical analysis of the Nantong pilot. Frontiers in Public Health10: 1024491.
19.
HalfonNLarsonKSonJ, et al. (2017) Income inequality and the differential effect of adverse childhood experiences in US Children. Academic Pediatrics17(7s): S70–s78.
20.
HerrmannMPuscedduIMärzW, et al. (2018) Telomere biology and age-related diseases. Clinical Chemistry and Laboratory Medicine (CCLM)56(8): 1210–1222.
21.
HeYZhangYCuiX, et al. (2021) Epidemiology of major childhood adversities and its effect on depression and suicide attempts in Chinese college students. Journal of Affective Disorders281: 331–337.
22.
HoutepenLCHeronJSudermanMJ, et al. (2020) Associations of adverse childhood experiences with educational attainment and adolescent health and the role of family and socioeconomic factors: A prospective cohort study in the UK. Plos Medicine17(3): e1003031.
23.
HughesKBellisMAHardcastleKA, et al. (2017) The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. Lancet Public Health2(8): e356–e366.
24.
KendigHBrowningCJThomasSA, et al. (2014) Health, lifestyle, and gender influences on aging well: An Australian longitudinal analysis to guide health promotion. Frontiers in Public Health2: 70.
25.
KobayashiLC (2024) Adverse Childhood Experiences and later-life cognitive aging: Persistent methodological challenges limit the evidence base. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences79(8): glae138.
26.
LangJMcKieJSmithH, et al. (2020) Adverse childhood experiences, epigenetics and telomere length variation in childhood and beyond: A systematic review of the literature. European Child & Adolescent Psychiatry29(10): 1329–1338.
27.
LiJLinSYanX, et al. (2022) Adverse childhood experiences and trajectories of ADL disability among middle-aged and older adults in China: Findings from the CHARLS Cohort Study. Journal of Nutrition Health & Aging26(12): 1034–1041.
28.
LinLCaoBChenW, et al. (2022) Association of Adverse Childhood Experiences and social isolation with later-life cognitive function among adults in China. JAMA Network Open5(11): e2241714.
29.
LinLWangHHLuC, et al. (2021) Adverse childhood experiences and subsequent chronic diseases among middle-aged or older adults in China and associations with demographic and socioeconomic characteristics. JAMA Network Open4(10): e2130143.
30.
LiuHBylesJEXuX, et al. (2016) Association between nighttime sleep and successful aging among older Chinese people. Sleep Medicine22: 18–24.
31.
McLaughlinSJConnellCMHeeringaSG, et al. (2010) Successful aging in the United States: Prevalence estimates from a national sample of older adults. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 65b(2): 216–226.
32.
MengXD’ArcyC (2014) Successful aging in Canada: Prevalence and predictors from a population-based sample of older adults. Gerontology60(1): 65–72.
33.
PierceHJonesMSHolcombeEA (2022) Early adverse childhood experiences and social skills among youth in fragile families. Journal of Youth and Adolescence51(8): 1497–1510.
34.
PruchnoRSandsLPCartwrightFP, et al. (2024) Subjective successful aging predicts probability of mortality over 9 years among adults aged 50–74. Gerontologist64(7): gnad148.
35.
RaoCBundhamcharoenKKellyM, et al. (2021) Mortality estimates for WHO SEAR countries: Problems and prospects. BMJ Global Health6(11): e007177.
36.
RodNHBengtssonJBudtz-JørgensenE, et al. (2020) Trajectories of childhood adversity and mortality in early adulthood: A population-based cohort study. Lancet396(10249): 489–497.
SoaresALHoweLDMatijasevichA, et al. (2016) Adverse childhood experiences: Prevalence and related factors in adolescents of a Brazilian birth cohort. Child Abuse & Neglect51: 21–30.
40.
SugliaSFKoenenKCBoynton-JarrettR, et al. (2018) Childhood and adolescent adversity and cardiometabolic outcomes: A Scientific Statement from the American Heart Association. Circulation137(5): e15–e28.
41.
ZhaoYHuYSmithJP, et al. (2014) Cohort profile: The China Health and Retirement Longitudinal Study (CHARLS). International Journal of Epidemiology43(1): 61–68.
42.
ZhuXZhangXDingL, et al. (2023) Associations of pain and sarcopenia with successful aging among older people in China: Evidence from CHARLS. Journal of Nutrition Health & Aging27(3): 196–201.
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