Nilaweera Dinuli, Freak-Poli Rosanne, Gurvich Caroline, Ritchie Karen, Chaudieu Isabelle, Ancelin Marie-Laure, Ryan Joanne
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Central Clinical School, Monash University, Melbourne, Victoria, Australia.
J Affect Disord. 2022 May 1;304:128-132. doi: 10.1016/j.jad.2022.02.062. Epub 2022 Feb 24.
Considerable work exists in the literature to describe the negative impacts of early-life stress exposures on health in adulthood. This study investigated whether the accumulation of adverse childhood events is associated with later-life cognitive function and incident dementia.
Participants were 1562 community-dwelling older adults, who were enrolled in the ESPRIT cohort in France. Adverse childhood events were measured using a modified version of the Childhood Trauma Questionnaire. Cognition was measured using tests of global cognition, visual memory, verbal fluency, psychomotor speed and executive function. Fourteen-year incident dementia was diagnosed using DSM-IV criteria.
In comparison to participants with two or less adverse childhood events, increased risk of poor psychomotor speed at baseline was observed in individuals with multiple adverse childhood events (3-4 events OR: 1.39, 95% CI: 1.00-1.93); ≥5 events (OR: 1.52, 95% CI: 1.07-2.17), particularly in women but not in men. Worse verbal fluency was also observed in individuals who experienced between three and four adverse childhood events (OR: 1.34, 95% CI: 1.00-1.78). Amongst the individual factors investigated, early-life abuse/maltreatment (OR: 1.47, 95% CI: 1.02-2.14) and poverty/financial difficulties (OR: 1.53, 95% CI: 1.12-2.08) was associated with worse psychomotor speed. No associations were observed with incident dementia.
Participants most at risk (those with baseline dementia) were excluded.
Multiple adverse childhood events are associated with worse psychomotor speed, and verbal fluency in later-life, however further research is needed to determine the mechanisms underlying this association and whether it results from unmeasured confounding, including social disadvantage.
文献中有大量研究描述了早年应激暴露对成年期健康的负面影响。本研究调查了童年不良事件的累积是否与晚年认知功能及痴呆症发病有关。
研究对象为1562名居住在社区的老年人，他们参与了法国的ESPRIT队列研究。童年不良事件通过修订版儿童创伤问卷进行测量。认知功能通过整体认知、视觉记忆、语言流畅性、心理运动速度和执行功能测试来评估。根据《精神疾病诊断与统计手册》第四版标准诊断14年内发生的痴呆症。
与童年不良事件为两件及以下的参与者相比，童年不良事件为多件（3 - 4件：比值比[OR]：1.39，95%置信区间[CI]：1.00 - 1.93）；≥5件（OR：1.52，95% CI：1.07 - 2.17）的个体在基线时心理运动速度较差的风险增加，尤其在女性中，男性则不然。童年不良事件为3至4件的个体语言流畅性也较差（OR：1.34，95% CI：1.00 - 1.78）。在所调查的个体因素中，早年遭受虐待/ maltreatment（OR：1.47，95% CI：1.02 - 2.14）以及贫困/经济困难（OR：1.53，95% CI：1.12 - 2.08）与心理运动速度较差有关。未观察到与痴呆症发病的关联。
排除了风险最高的参与者（那些基线时患有痴呆症的人）。
童年多件不良事件与晚年较差的心理运动速度和语言流畅性有关，然而需要进一步研究以确定这种关联背后的机制，以及它是否由未测量的混杂因素导致，包括社会劣势。
