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Published on: January 24, 2020
Association of Adverse Childhood Experiences and Cognitive Health in Older Adults: Rush Memory and Aging Project
Jocelyn Jaen1, Melissa Lamar1, Brittney S Lange-Maia1
1Rush Alzheimer's Disease Center, Rush University Medical Center (JJ, ML, BSLM, DAB, FG), Chicago, IL; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center (ML), Chicago, IL; Department of Family and Preventive Medicine, Rush University Medical Center (BSLM), Chicago, IL; Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences (DTNM), Los Angeles, CA; SECIHTI - Center for Population Health Research, National Institute of Public Health (LGFR), Ciudad de México, Mexico; Center for Population Health Research, National Institute of Public Health (JJ, ML), Ciudad de México, Mexico; Department of Global Health and Population, Harvard T.H. Chan School of Public Health (ML), Boston, MA; Department of Neurological Sciences, Rush University Medical Center (DAB), Chicago, IL; and the Department of Internal Medicine, Rush University Medical Center (FG), Chicago, IL.
Objective:
To examine the association between adverse childhood experiences (ACEs) and cognitive function and decline in older adults.
Design:
Analysis of baseline cognitive and annual rates of cognitive decline in participants from the Rush Memory and Aging Project (MAP).
Setting:
MAP is an ongoing cohort of older adults initiated in 1997.
Participants:
1,869 participants without dementia at baseline.
Measurements:
ACEs were assessed using a 16-item questionnaire covering emotional neglect, financial need, parental intimidation, parental violence, and family turmoil. Cognitive function was evaluated annually using 19 neuropsychologic tests across five domains. Linear mixed-effects models estimated associations of ACEs with baseline global cognition and cognitive decline.
Results:
At baseline, participants had a mean age of 80 years and 15 years of education; 26% were male, and 92% were non-Latino White. The average total ACE score was 8.3 points (SD 7.6) of a possible 58 points; the mean follow-up was 7.6 years (SD 4.9). Total ACE score was not associated with baseline global cognition or with the annual rate of global cognitive decline. However, each increment of parental violence (mean difference = -0.032 standard units, p = 0.004), family turmoil (mean difference = -0.027, p = 0.007), and financial need (mean difference = -0.024, p = 0.01) was associated with lower baseline global cognition. Emotional neglect was associated with a steeper, annual rate of global cognitive decline (mean difference = -0.0014, p = 0.027).
Conclusion:
The total ACE score was not associated with cognitive health in later life. However, specific ACE dimensions, including parental violence, family turmoil, and financial need, may be related to baseline cognitive function in older persons.
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