History of sexual assault is associated with greater declines in executive functioning in older adults with APOE epsilon4.

OBJECTIVES

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.

METHOD

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.

RESULTS

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.

DISCUSSION

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.