Evidence map›Paper›PMID 42789523›Full record

ArticlePloS one2026

The impact of adverse childhood experiences on the development of multimorbidity in older adults in Nigeria.

Abdulsalam Ahmed, Hafiz T A Khan, Nestor Asiamah

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Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Abdulsalam AhmedDepartment of Public Health/Community Health, Newgate University Minna, Niger state Nigeria & Ranc Orbit International Ltd/Gte, Minna, Niger State, Nigeria.
Hafiz T A KhanCollege of Nursing, Midwifery, and Healthcare, University of West London, London, United Kingdom.ORCID https://orcid.org/0000-0002-1817-3730
Nestor AsiamahSchool of Health and Social Care, University of Essex, Colchester, Essex, United Kingdom.ORCID https://orcid.org/0000-0002-1157-6430

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdverse Childhood Experiences (ACEs) are established life-course determinants of adult health, yet evidence linking ACEs to multimorbidity in sub-Saharan Africa remains limited. Nigeria is undergoing rapid demographic and epidemiological transitions characterized by population ageing and a rising burden of non-communicable diseases (NCDs). This study examined whether cumulative ACE exposure predicts multimorbidity among older adults in North-Central Nigeria.

methodsA cross-sectional study was conducted among 734 adults aged ≥60 years in Niger State, Nigeria. ACE exposure before age 18 was assessed using the Adverse Childhood Experiences International Questionnaire (ACE-IQ) across 13 domains. Multimorbidity was defined as the presence of two or more chronic conditions (NICE criteria) from a list of 24 conditions and analyzed both as a count and dichotomized (≥3 vs. < 3 conditions). Descriptive statistics summarized participant characteristics. Chi-square tests examined bivariate associations. Hierarchical logistic regression models estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to determine independent predictors of multimorbidity.

resultsHigh cumulative ACE exposure was observed, with 68.4% reporting ≥4 ACEs. Multimorbidity was common: 38.4% reported three or more chronic conditions. ACE exposure was strongly associated with multimorbidity (χ² = 116.07, p < 0.001). In unadjusted analysis, participants reporting ≥4 ACEs had significantly higher odds of multimorbidity (OR = 67.14; 95% CI: 9.25-487.04). After adjusting for socio-demographic covariates, cumulative ACE exposure remained an independent predictor (OR = 15.58; 95% CI: 1.33-182.21). Advanced age (≥80 years) and living in three-generation households were also independently associated with multimorbidity.

conclusionsCumulative childhood adversity significantly predicts multimorbidity among older Nigerian adults, demonstrating a clear dose-response relationship. These findings underscore the importance of life-course approaches and trauma-informed strategies in public health policy. Early identification and prevention of childhood adversity may contribute to reducing the long-term burden of multimorbidity in low- and middle-income settings.

Indexed as

Adverse Childhood ExperiencesMultimorbidityAgedAged, 80 and overChronic DiseaseCross-Sectional StudiesFemaleHumansMaleMiddle AgedNigeriaOdds Ratio

Identifiers

PMID42789523
PMCPMC13614559

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.