San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, La Jolla, CA 92093-9111, USA.
J Gerontol B Psychol Sci Soc Sci. 2012 Nov;67(6):653-9. doi: 10.1093/geronb/gbr163. Epub 2012 Feb 22.
This study examined the longitudinal association between a prior history of sexual assault (SA), typically in youth, and decreasing executive functioning (EF) in old age and whether the apolipoprotein (APOE) ε4 allele modifies this relationship.
In this longitudinal study, 846 community-dwelling older adults at baseline completed questions about SA history and two tests of EF. Over the 10 years following this baseline visit, participants completed up to 3 follow-up cognitive assessments. Mixed-effects models first examined the longitudinal association between SA and EF performance. Last, preplanned analyses examined whether the APOE ε4 allele modified this association.
A single SA exposure was not associated with EF declines. Repeated SA exposure was associated with steeper declines in both EF measures. For Trails B, there was a significant interaction between any SA exposure and the APOE ε4 allele, such that having either repeated or isolated SA as well as APOE ε4 was associated with faster decline.
SA exposure earlier in life may increase risk for declines in EF 50-60 years later in old age, particularly in the context of the APOE ε4 allele. These results generally support a diathesis-stress model of decreased cognitive reserve.
本研究考察了既往性侵犯（SA）史，通常发生在年轻时，与老年时执行功能（EF）下降之间的纵向关联，以及载脂蛋白（APOE）ε4 等位基因是否会改变这种关系。
在这项纵向研究中，846 名基线时居住在社区的老年人完成了关于 SA 史和两项 EF 测试的问题。在基线检查后的 10 年内，参与者完成了最多 3 次随访认知评估。混合效应模型首先检验了 SA 与 EF 表现之间的纵向关联。最后，进行了预先计划的分析，以检验 APOE ε4 等位基因是否改变了这种关联。
单次 SA 暴露与 EF 下降无关。重复 SA 暴露与两种 EF 测量值的下降更为陡峭有关。对于 Trails B，任何 SA 暴露与 APOE ε4 等位基因之间存在显著的相互作用，因此，重复或孤立的 SA 以及 APOE ε4 都与更快的下降有关。
年轻时的 SA 暴露可能会增加 50-60 年后老年 EF 下降的风险，特别是在 APOE ε4 等位基因的背景下。这些结果总体上支持认知储备减少的素质-应激模型。
