Loneliness Links Adverse Childhood Experiences to Mortality Risk Across 26 Years

Objectives: Adverse childhood experiences (ACEs) are associated with increased mortality risk. Individuals with a history of certain adversity during childhood tend to report higher levels of loneliness in later life. In our preregistered study, we examined whether loneliness mediates the ACEs to mortality risk relation. Methods: Participants were from the Midlife in the United States Survey (N=4,963; M [SD] = 46.44 [12.52] years, 53.3% female). Follow-up period spanned 26 years. A comprehensive measure of ACEs was employed consisting of 20 ACEs from 5 categories: physical abuse, emotional abuse, socioeconomic disadvantage, adverse family structure, and poor health at age 16 years. Results: ACE was a significant predictor of mortality risk. Loneliness mediated the ACEs-mortality risk relation. In other words, loneliness in adulthood accounted for the relation between ACEs and future death. These effects withstood a range of sensitivity checks and adjustments for important factors, such as social isolation. Discussion: Loneliness appears to be a central mechanism in the long-term impact of ACEs on longevity, such that, for adversity during childhood, loneliness experienced during adulthood may be a toxic pathway to future death.