University of Groningen, University Medical Center Groningen, Rob Giel Research Center (RGOc), PO Box 30.001, 9700 HB, Groningen, The Netherlands.
Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Jundiaí, Brazil.
BMC Geriatr. 2022 Apr 28;22(1):377. doi: 10.1186/s12877-022-03068-6.
Child abuse is a major global burden with an enduring negative impact on mental and physical health. A history of child abuse is consistently associated with worse cognitive performance among adults; data in older age groups are inconclusive. Since affective symptoms and cognitive functioning are interrelated among older persons, a synergistic effect can be assumed in patients with affective symptoms who also have suffered from child abuse. This study examines the association between a history of child abuse and cognitive performance in such patients.
Cross-sectional data were collected from the 'Routine Outcome Monitoring for Geriatric Psychiatry & Science' project, including 179 older adults (age 60-88 years) with either a unipolar depressive, any anxiety, or somatic symptom disorder referred to specialized geriatric mental health care. A history of physical, sexual, and psychological abuse, and emotional neglect was assessed with a structured interview. Cognitive functioning was measured with three paper and pencils tests (10-words verbal memory test, Stroop Colour-Word test, Digit Span) and four tests from the computerized Cogstate Test Battery (Detection Test, Identification Test, One Card Learning Test, One Back Test). The association between a history of child abuse and cognitive performance was examined by multiple linear regression analyses adjusted for covariates.
Principal component analyses of nine cognitive parameters revealed four cognitive domains, i.e., visual-verbal memory, psychomotor speed, working memory and interference control. A history of child abuse was not associated with any of these cognitive domains. However, when looking at the specific types of child abuse separately, a history of physical abuse and emotional neglect were associated with poorer interference control. A history of physical abuse was additionally associated with better visual-verbal memory.
The association between a history of child abuse and cognitive performance differs between the different types of abuse. A history of physical abuse might particularly be a key determinant of cognitive performance in older adults with a depressive, anxiety, or somatic symptom disorder. Future studies on the impact of these disorders on the onset of dementia should take child abuse into account.
ROM-GPS is registered at the Dutch Trial Register ( NL6704 at www.trialregister.nl ).
儿童虐待是一个全球性的主要负担，对身心健康有着持久的负面影响。儿童期虐待史与成年人认知表现较差密切相关；但在老年人群中数据尚无定论。由于老年人的情感症状和认知功能相互关联，因此可以假设在患有情感症状且遭受过儿童虐待的患者中存在协同效应。本研究旨在研究儿童虐待史与这类患者认知表现之间的关系。
本研究从“老年精神病学和科学常规结果监测”项目中收集了横断面数据，包括 179 名年龄在 60-88 岁之间的老年人（单相抑郁、任何焦虑或躯体症状障碍），他们被转诊至专门的老年精神保健机构。使用结构化访谈评估了他们的身体、性和心理虐待史，以及情感忽视史。使用三种纸笔测试（10 词言语记忆测试、Stroop 颜色-文字测试、数字跨度）和计算机化 Cogstate 测试电池中的四项测试（检测测试、识别测试、一卡学习测试、一背测试）来测量认知功能。通过调整协变量的多元线性回归分析，研究了儿童虐待史与认知表现之间的关系。
对 9 项认知参数的主成分分析揭示了 4 个认知领域，即视觉-言语记忆、心理运动速度、工作记忆和干扰控制。儿童虐待史与这些认知领域均无关。然而，当分别单独观察特定类型的儿童虐待时，身体虐待和情感忽视史与较差的干扰控制相关。身体虐待史还与更好的视觉-言语记忆相关。
儿童虐待史与认知表现之间的关系因虐待类型而异。身体虐待史可能是老年患有抑郁、焦虑或躯体症状障碍患者认知表现的关键决定因素。未来关于这些疾病对痴呆症发病影响的研究应考虑儿童虐待史。
ROM-GPS 在荷兰试验注册库（NL6704，网址为 www.trialregister.nl）注册。
