{
  "abstract": "Background: Adverse 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. Methods: A 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. Results: High 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. Conclusions: Cumulative 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.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Public Health/Community Health, Newgate University Minna, Niger state Nigeria & Ranc Orbit International Ltd/Gte, Minna, Niger State, Nigeria",
    "College of Nursing, Midwifery, and Healthcare, University of West London, London, United Kingdom",
    "Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Abdulsalam Ahmed"
    },
    {
      "affs": [
        1
      ],
      "name": "Hafiz T. A. Khan"
    },
    {
      "affs": [
        2
      ],
      "name": "Nestor Asiamah"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b3cyhv02ndg5c.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0358944",
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  "id": "b3cyhv02ndg5c",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0358944",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3203|Child Abuse and Trauma"
    ],
    [
      "plos",
      "/Medicine and health sciences/Epidemiology/Medical risk factors"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pediatrics/Child health"
    ],
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      "plos",
      "/Medicine and health sciences/Pharmaceutics/Dose prediction methods"
    ],
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      "plos",
      "/Medicine and health sciences/Public and occupational health"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health/Child health"
    ],
    [
      "plos",
      "/People and places/Geographical locations/Africa/Nigeria"
    ],
    [
      "plos",
      "/People and places/Population groupings/Age groups/Adults/Elderly"
    ],
    [
      "plos",
      "/Social sciences/Sociology/Education/Schools"
    ],
    [
      "plos",
      "/Social sciences/Sociology/Human families"
    ]
  ],
  "openalex": "W7214386018",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0358944&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-25",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/b3cyhv02ndg5c.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:43Z",
      "native_id": "10.1371/journal.pone.0358944",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0358944"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "The impact of adverse childhood experiences on the development of multimorbidity in older adults in Nigeria",
  "title_text": "The impact of adverse childhood experiences on the development of multimorbidity in older adults in Nigeria",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:43Z",
  "url": "https://research.draconitic.com/paper/b3cyhv02ndg5c",
  "venue": "PLOS One",
  "versions": []
}