Background Child maltreatment (abuse and neglect) has established associations with mental health; however, little is known about its relationship with physical functioning as few studies have been undertaken. Physical functioning in adulthood is an important outcome to consider, as it is strongly associated with an individual’s ability to work, and future disability, dependency, hospitalisations and mortality. We aimed to establish whether maltreatment was associated with physical functioning, independent from other early-life adversities.
Methods Using data from the 1958 British birth cohort (n=8150), we examined associations between child neglect and physical, psychological, witnessing and sexual abuse with physical functioning at age 50. Poor physical functioning was defined by those scoring <65 on the Short-Form 36 (SF-36) Physical Functioning scale. We also examined two secondary outcomes – mental health and self-reported health at age 50. Associations between each maltreatment and outcome were assessed using logistic regression with and without adjustment for covariates, including childhood social class, birthweight, childhood health, parental chronic illness, and parental education.
Results 23% of participants reported at least one type of maltreatment and 12% were identified with poor physical functioning. Neglect, psychological, and sexual abuse were associated with poor physical functioning independent of all covariates and other maltreatments: ORadj1.55 (95% CI 1.24–1.93), 1.49 (1.17–1.88) and 2.56 (1.66–3.96), respectively. Odds of poor physical functioning increased with multiple types of maltreatment; 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 to those with none. Associations of comparable magnitude were observed for mental and self-reported health outcomes; e.g. ORadj varied between 1.42–1.55 for neglect across the three adult outcomes.
Conclusion 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. To our knowledge, we are the first to demonstrate that these associations are independent of numerous early-life adversities, and comparable in magnitude to those observed for mental health and self-rated health. Our findings underscore the importance of the prevention of maltreatment and the alleviation of its ill-effects to promote healthy ageing.
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