ObjectiveChild maltreatment (abuse and neglect) has established associations with mental health; however, little is known about its relationship with physical functioning. Physical functioning (ie, the ability to perform the physical tasks of daily living) in adulthood is an important outcome to consider, as it is strongly associated with an individual’s ability to work, and future disability and dependency. We aimed to establish whether maltreatment was associated with physical functioning, independent of other early-life factors.Setting1958 British birth cohort.Participants8150 males and females with data on abuse and who participated at age 50 years.Outcome measuresThe primary outcome was poor physical functioning at 50 years (<65 on the Short-Form 36 survey physical functioning subscale). Secondary outcomes included mental health and self-reported health at 50 years.Results23% of participants reported at least one type of maltreatment; 12% were identified with poor physical functioning. Neglect (ORadj1.55, 95% CI 1.24 to 1.93), psychological abuse (ORadj1.49, 1.17–1.88) and sexual abuse (ORadj2.56, 1.66–3.96) were associated with poor physical functioning independent of other maltreatments and covariates, including childhood social class, birth weight and childhood illness. Odds of poor physical functioning increased with multiple types of maltreatment (ptrend<0.001); ORadjranged 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 with those with none. Associations of similar magnitude were observed for mental and self-reported health outcomes.ConclusionsChild neglect, psychological and sexual abuse were associated with poor physical functioning at 50 years, with accumulating risk for those with multiple types of maltreatment. Associations were independent of numerous early-life factors and were comparable in magnitude to those observed for mental health and self-rated health. Prevention or alleviation of the ill effects of maltreatment could be an effective policy intervention to promote healthy ageing.
Lung function trajectories from pre-school age to adulthood and their associations with early life factors: a retrospective analysis of three population-based birth cohort studies
