{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:38:25Z","timestamp":1792633105598,"version":"4.5.0"},"reference-count":70,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72374205"],"award-info":[{"award-number":["72374205"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adverse childhood experiences (ACEs) are associated with sarcopenia, but underlying pathways remain unclear. This study aimed to examine whether depressive symptoms and cognitive impairment mediate or moderate the associations of threat\u2010related and deprivation\u2010related ACEs with sarcopenia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Three waves (2011\u20132015) of the China Health and Retirement Longitudinal Study (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095003, aged \u2265\u200960\u2009years) were used. Logistic regression and Cox proportional hazards regression tested associations of ACE dimensions, depressive symptoms, and cognitive impairment with sarcopenia. Four\u2010way decomposition and joint multiple mediator analysis quantified mediation and interaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Deprivation\u2010related ACEs were associated with sarcopenia (HR\u2009=\u20091.143, 95% CI\u2009=\u20091.013\u20131.289), whereas threat\u2010related ACEs were not (HR\u2009=\u20091.002, 95% CI\u2009=\u20090.896\u20131.120). In four\u2010way decomposition, threat\u2010related ACEs showed no significant total or direct effect. The small pure indirect effect (PIE) via depressive symptoms (HR\u2009=\u20091.025, 95% CI\u2009=\u20091.008\u20131.044) is hypothesis\u2010generating. For deprivation\u2010related ACEs, significant components comprised a direct effect independent of depressive symptoms (HR\u2009=\u20091.222, 95% CI\u2009=\u20091.035\u20131.436), a small PIE via depressive symptoms (HR\u2009=\u20091.014, 95% CI\u2009=\u20091.004\u20131.027), and a reference interaction with cognitive impairment (HR\u2009=\u20091.046, 95% CI\u2009=\u20091.006\u20131.089), reflecting a significant multiplicative interaction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). Joint mediator analysis corroborated the non\u2010significant total effect of threat\u2010related ACEs, although a small joint indirect effect emerged (HR\u2009=\u20091.020, 95% CI\u2009=\u20091.005\u20131.036). For deprivation\u2010related ACEs, total effect (HR\u2009=\u20091.140, 95% CI\u2009=\u20091.006\u20131.284) was predominantly direct, and the joint indirect effect explained 11.4%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Deprivation\u2010related ACEs increased sarcopenia risk through direct pathways and amplified vulnerability among individuals with cognitive impairment, with a minor indirect contribution from depressive symptoms. Threat\u2010related ACEs showed no significant total effect. The weak indirect effect via depressive symptoms requires replication. Dimension\u2010specific ACE assessment and targeted psychological intervention are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70882","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:44:18Z","timestamp":1792629858000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Adverse Childhood Experiences and Later\u2010Life Sarcopenia Among Community\u2010Dwelling Older Adults: Mediating and Moderating Roles of Depressive Symptoms and Cognitive Impairment"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2672-4341","authenticated-orcid":false,"given":"Qinqin","family":"Liu","sequence":"first","affiliation":[{"name":"School of Nursing Naval Medical University  Shanghai China"},{"name":"Changhai Hospital of Shanghai Naval Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Nursing Naval Medical University  Shanghai China"},{"name":"Key Laboratory of Geriatric Long\u2010Term Care (Naval Medical University), Ministry of Education  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibin","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Basic Medical Science Naval Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Wang","sequence":"additional","affiliation":[{"name":"905 Hospital of People's Liberation Army Navy  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0659-9371","authenticated-orcid":false,"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing Naval Medical University  Shanghai China"},{"name":"Key Laboratory of Geriatric Long\u2010Term Care (Naval Medical University), Ministry of Education  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"10191","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1016\/S0140-6736(19)31138-9","article-title":"Sarcopenia","volume":"393","author":"Cruz\u2010Jentoft A. 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