Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
University of California Los Angeles, CA, USA.
Child Maltreat. 2022 Feb;27(1):100-113. doi: 10.1177/1077559520970647. Epub 2020 Nov 9.
Cognitive function at middle age is of particular public health interest, as it strongly predicts later dementia. Children who have experienced abuse subsequently have worse cognitive function than those who have not. However, it remains unclear whether the association of abuse with cognitive function persists into middle age. In 2014-2016, 14,151 women ages 49-69 years who had previously responded to a childhood abuse questionnaire completed a cognitive battery. In models adjusted for childhood socioeconomic status and head trauma, combined physical, emotional, and sexual abuse was associated with lower scores on both Learning/Working Memory (severe abuse, lower scores similar to that observed in women 4.8 years older in our data) and Psychomotor Speed/Attention (severe abuse, lower scores similar to that observed in women to 2.9 years older in our data). Adjustment for adulthood socioeconomic status and health factors (e.g., smoking, hypertension) slightly attenuated associations. In exploratory analyses further adjusted for psychological distress, associations were attenuated. Women exposed versus unexposed to childhood abuse had poorer cognitive function at mid-life. Associations were particularly strong for learning and working memory and were not accounted for by adulthood health factors. Childhood abuse should be investigated as a potential risk factor for cognitive decline and dementia in old age.
中年时期的认知功能尤其受到公共卫生的关注,因为它强烈预示着以后会发生痴呆症。与没有经历过虐待的儿童相比,经历过虐待的儿童的认知功能更差。然而,目前尚不清楚虐待与认知功能的关联是否会持续到中年。2014-2016 年,14151 名年龄在 49-69 岁之间的女性曾在前一个儿童虐待问卷中做出过回应,完成了一个认知测试。在调整了儿童时期的社会经济地位和头部创伤因素后,身体、情感和性虐待的综合影响与学习/工作记忆(严重虐待,分数与我们数据中年龄大 4.8 岁的女性相似)和心理运动速度/注意力(严重虐待,分数与我们数据中年龄大 2.9 岁的女性相似)的分数降低有关。调整成年后的社会经济地位和健康因素(如吸烟、高血压)后,相关性略有减弱。在进一步调整了心理困扰等因素的探索性分析中,相关性减弱。与没有经历过儿童期虐待的女性相比,经历过儿童期虐待的女性在中年时期的认知功能较差。这些关联在学习和工作记忆方面尤为强烈,并且不能用成年后的健康因素来解释。应该将儿童期虐待作为老年认知能力下降和痴呆症的潜在风险因素进行调查。