Adverse Childhood Experiences and Chronic Obstructive Pulmonary Disease in Adults

Background Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality in the U.S. However, little is known about the influence of childhood stressors on its occurrence. Methods Data were from 15,472 adult HMO members enrolled in the Adverse Childhood Experiences (A...

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Bibliographic Details
Published in:American journal of preventive medicine 2008-05, Vol.34 (5), p.396-403
Main Authors: Anda, Robert F., MD, MS, Brown, David W., MSPH, MS, Dube, Shanta R., PhD, MPH, Bremner, J. Douglas, MD, Felitti, Vincent J., MD, Giles, Wayne H., MD, MS
Format: Article
Language:English
Subjects:
Adult
Adult Survivors of Child Abuse - psychology
Adulthood
Age Factors
Aged
California - epidemiology
Child
Childhood experiences
Chronic obstructive pulmonary disease
Domestic Violence
Female
Hospitalization
Humans
Internal Medicine
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive - drug therapy
Pulmonary Disease, Chronic Obstructive - epidemiology
Pulmonary Disease, Chronic Obstructive - etiology
Pulmonary Disease, Chronic Obstructive - physiopathology
Retrospective Studies
Risk Assessment
Stressful events
USA
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Summary:Background Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality in the U.S. However, little is known about the influence of childhood stressors on its occurrence. Methods Data were from 15,472 adult HMO members enrolled in the Adverse Childhood Experiences (ACE) Study from 1995 to 1997 and eligible for the prospective phase. Eight ACEs were assessed: abuse (emotional, physical, sexual); witnessing domestic violence; growing up with substance-abusing, mentally ill, or criminal household members; and parental separation or divorce. The number of ACEs (ACE Score) was used to examine the relationship of childhood stressors to the risk of COPD. Three methods of case ascertainment were used to define COPD: baseline reports of prevalent COPD, incident hospitalizations with COPD as a discharge diagnosis, and rates of prescription medications to treat COPD during follow-up. Follow-up data were available through 2004. Results The ACE Score had a graded relationship to each of three measures of the occurrence of COPD. Compared to people with an ACE Score of 0, those with an ACE Score of ≥5 had 2.6 times the risk of prevalent COPD, 2.0 times the risk of incident hospitalizations, and 1.6 times the rates of prescriptions ( p
ISSN:0749-3797
1873-2607
DOI:10.1016/j.amepre.2008.02.002