Public Health.

Area of Science:

• Neuroscience
• Public Health
• Gerontology

Background:

• Previous research on adverse experiences and dementia is limited by narrow focus, unrepresentative samples, and short follow-up periods.
• Cumulative trauma measures oversimplify the impact of individual adverse experiences on dementia risk.
• A more representative UK sample is needed to identify specific adverse experiences linked to dementia.

Purpose of the Study:

• To investigate associations between cumulative and categorical measures of adverse life experiences and dementia incidence.
• To determine which specific adverse experiences, rather than cumulative trauma, drive dementia risk.
• To examine effect modification by sex and childhood economic hardship.

Main Methods:

• Utilized retrospective life history interviews from the English Longitudinal Study of Ageing.
• Analyzed adverse experiences singly, grouped into broad categories, and as total counts.
• Employed logistic regression and Cox proportional hazard models to assess dementia risk associations.

Main Results:

• Total count measures of lifetime adversity showed little association with dementia incidence.
• Child abuse was linked to a 75% increased hazard of dementia (HR: 1.75).
• Severe adult economic hardship increased dementia hazard by 32% (HR: 1.32); adult household challenges increased risk significantly only with prior childhood economic hardship (HR: 2.99).

Conclusions:

• Child abuse and severe adult economic hardship are significant risk factors for dementia.
• Additive approaches to adverse experiences may obscure the impact of specific events.
• Future research should focus on the modifiability of these identified risk exposures.