The Effects of Lifetime Trauma Exposure on Cognitive Functioning in Midlife

Accumulating evidence suggests that lifetime trauma exposure is associated with adulthood cognitive functioning. However, the nature and extent of this relation have yet to be fully explored. We used multilevel modeling to examine trauma exposure and age at first trauma exposure as predictors of the level of and change in cognitive functioning over a 9-year period. Data were from the Midlife in the United States study, a national survey that began in 1995. Data regarding trauma exposure and age at first exposure were obtained from the 2004 wave, whereas cognitive data were obtained from the 2004 and 2013 waves. The analyses were conducted using data from the 2,471 participants (age range: 28-84 years) who had complete data on all variables from the 2004 wave. Lifetime trauma exposure predicted change in executive functioning (EF), B = -0.03, SE = 0.01, p = .015, 95% CI [-0.05, -0.01]; and episodic memory, B = -0.05, SE = 0.02, p = .023, 95% CI [-0.10, -0.01], such that individuals with more trauma exposure had more decline over 9 years. Age at first exposure also predicted change in EF, B = -0.002, SE = 0.00, p = .009, 95% CI [-0.004, -0.001], such that individuals who were first exposed to trauma later in life had greater EF decline than individuals whose first traumatic event occurred earlier in life. Delta pseudo- $$ values were moderate, ΔpseudoR^{2 =} .17-.39. These findings identify trauma exposure as a risk factor for cognitive decline in adulthood and highlight the elevated risk associated with adulthood trauma exposure.