1040 - Adverse Childhood Experiences and Arthritis-Related Functioning and Disability

To evaluate the relationship between adverse childhood experiences (ACEs) and arthritis and arthritis-related functional limitations, participation restrictions and pain.

Design:

We combined data from the 2019-2022 Behavioral Risk Factor Surveillance System, a cross-sectional population-based survey of community-dwelling adults (n= 396,532) to assess the relationship between ACEs and arthritis and difficulty with mobility. In 2019 and 2021, participants reporting arthritis (n=72,393) were asked additional questions about arthritis-related activity limitations, work participation restrictions and joint pain and receipt of arthritis education and exercise prescription. The ACE questions asked about experiences of abuse (sexual, physical, emotional) and family dysfunction (domestic violence, caregiver mental illness, substance abuse, imprisonment, divorce/separation) occurring prior to age 18. The complex survey procedures in SAS9.4 were used for all analyses including descriptive statistics and logistic regression adjusting for age, sex, and race/ethnicity.

Results: As ACE count increased, the adjusted odds of arthritis increased stepwise from 1.4 [95% Confidence Interval (CI) 1.3-1.5] in those reporting 1 ACE to 5.3 [4.2-6.7] in those with 8 ACEs compared to no ACEs. In those with arthritis, a similar pattern was seen with the adjusted odds of mobility difficulty increasing from 1.1 [1.0-1.3] in ACE 1 to 3.6 [2.6-5.2] in ACE 8 compared to no ACEs. In the 2019/2021 subset analysis, arthritis-related activity limitations, work participation restrictions and severe pain also increased in a stepwise fashion as ACE count increased. There was no difference in exercise prescription by ACE count, but those with an ACE count ≥ 5 had a higher odds of reporting arthritis-related education.

Conclusions: ACE exposure not only increases the odds of having arthritis, but it also has a strong impact on arthritis-related functioning and disability. It is vital that future studies investigate how ACE exposures lead to increased disability so effective interventions can be developed to improve function in those affected by ACEs