To examine the association between adverse childhood experiences(ACEs) and the 10‑year frailty development trajectories in Chinese middle‑aged and older adults,so as to provide evidence for life‑course‑oriented healthy ageing promotion strategies.

Using data from the China Health and Retirement Longitudinal Study(CHARLS) spanning 2011-2020,we identified frailty development trajectories through group‑based trajectory modelling,and applied multinomial Logistic regression to analyse the relationship between ACEs and these trajectories.

A total of 10 032 middle‑aged and older adults were included.The baseline frailty index was 0.14±0.09,and 78.86% of the respondents reported at least one ACE.Three frailty trajectories were identified in the Chinese sample:stable non‑frailty(65.9%),critical turning point(23.9%),and progressive frailty(10.1%).Multinomial Logistic regression showed that ACEs were significantly associated with frailty trajectories(P<0.05),and a higher number of ACEs was associated with a higher relative risk of belonging to more severe frailty trajectory groups(P<0.05).

ACEs are associated with the 10‑year frailty development trajectories in Chinese middle‑aged and older adults,suggesting that childhood adversity may be an important distal risk factor for the long‑term evolution of frailty in later life.This highlights the need for early prevention from a life‑course perspective and precise intervention in old age.