• By Natalia Gurevich | Examiner staff writer |
• Aug 3, 2023 Updated 14 hrs ago (SFExaminer.com)

A new UCSF study shows how childhood trauma can impact people later in life — but the data also creates a roadmap for how to care for victims as they get older.

The study, published Wednesday in the Journal of General Internal Medicine, looked at how “adverse childhood experiences” — such as physical violence or abuse, severe illness, family financial stress, or being separated from parents — affected children.

Those who experienced these events — particularly violence — were more likely to have both physical and cognitive issues in life, persisting even until old age, the study showed.

For example, people who dealt with violence at a young age were 40% more likely to have some sort of mobility impairment, such as trouble walking; 80% were more likely to have difficulty with daily activities later in life; and those who came from unhappy families were 40% more likely to have at last mild cognitive impairment.

While there is interest in how someone’s childhood can influence health later on in life, there is still more that could be done, said Dr. Alison Huang, one of the lead authors of the study. Huang is a UCSF professor of medicine and director of research in general internal medicine at UCSF Health.

The study’s authors said they hope the information they gleaned from study participants will improve geriatric care as more and more of the U.S. population gets older.

“Thinking about it, not only on the individual level of what we can do in our clinical care, but also on a broader societal level of how we can intervene on these upstream determinants of health,” said Dr. Anita Hargrave, one of the study’s authors and an assistant professor of medicine at UCSF.

Challenging policymakers and the larger community to acknowledge this part of people’s health will be an important step in addressing some of the societal structures that cause these types of traumas, Hargrave said.

“People who identify with having historically marginalized identities, racial and ethnic identities, particularly African American and Latinx folks, have a higher burden of ACEs,” she said, referring to “adverse childhood experiences.”

“Studies have shown that they experience four or more ACEs more frequently than people who identify with other racial and ethnic identities,” she said. “So thinking about how these societal structures, discrimination, racism, structural violence, all influence not only the experience of adverse childhood events or trauma, but also how it can be perpetuated over time.”

For the study, more than 3,300 Americans between ages 50 and 97 underwent physical performance testing that evaluated their balance and walking ability, along with their cognitive and memory functions.

Nationally, the Centers for Disease Control and Prevention says 60% of adults have experienced childhood trauma, which can lead to physical issues like cardiovascular disease and diabetes to mental health problems, like depression.

“This research is just another way of looking at how early childhood experiences can impact not only the expression of genes and your mental health, but also potentially the way that you think, the way that you walk, the different ways that you can have a quality of life throughout your lifetime,” Hargrave said.

“I think most clinicians caring for older adults are just focusing on what’s happening to them now in older age, and not thinking about how what’s happening with older age could potentially have had its origin when patients were really young,” Huang said.

The findings also indicate the importance of these events to the patients themselves.

“We’re seeing in this study is that people really remember these experiences that happened to them over 50 years ago,” said Hargrave. “And that is really something that they hold in their memory and may impact their health currently.”

Huang, Hargrave and the study’s other authors hope to continue building off its results. Huang said it could even lead to changes in healthcare.

“It’s certainly something that I would like to continue to explore,” said Huang. “I think that an exciting part of this field is, is the next step, which is what do we do about this information?”

While the study was just released recently, Huang said she is already considering the possibilities.

“We can identify best practices in taking care of people who have experienced trauma,” she said. “And that’s where the field really is growing now, and that’s what makes it such an exciting time to be doing violence prevention and addressing violence, through understanding its mechanisms to impact health.”