Childhood multimorbidity and depressive symptoms and functional limitations among mid-to-old adults from 31 countries.

BACKGROUND: Large numbers of children with chronic diseases can now live into adulthood and older age. Poor childhood health is linked to adverse health events in later life, but the associations of childhood multimorbidity with depressive symptoms and functional limitations remain underexplored.

METHODS: Data were from the Survey of Health, Ageing and Retirement in Europe, English Longitudinal Study of Ageing and Health and Retirement Study, which included samples from 31 countries (N = 138,540, aged 50 and older). Eight childhood chronic diseases diagnosed before age 15/16 were retrospectively reported, with 2 or more indicating childhood multimorbidity. Depressive symptoms (assessed by the Europe-depression Scale or the Centre for Epidemiologic Studies Depression Scale) and limitations in (instrumental) activities of daily living ([I]ADLs) and mobility-related limitations were recorded at multiple time points. Generalized estimating equations were used to estimate associations and weighted random-effect meta-analysis was performed to pool associations across countries.

RESULTS: Childhood multimorbidity was associated with depressive symptoms, ADL, IADL and mobility limitations, with odds ratios and 95 % confidence intervals of 1.74 (1.60-1.90), 1.75 (1.61-1.90), 1.73 (1.58-1.90), and 1.68 (1.50-1.89), respectively. The associations were similar for participants with and without adulthood multimorbidity (P for difference > 0.05). For ADL and IADL limitations, associations were more pronounced in adults aged<65y (P for difference = 0.008 and 0.014).

LIMITATIONS: Misclassification bias of childhood diseases; scale-based outcomes; potential covariates were not adjusted; no data from low- and middle-income regions.

CONCLUSIONS: Childhood multimorbidity was associated with depressive symptoms and functional limitations in later life, which were more pronounced in the younger elderly.