Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
G. H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
J Int Neuropsychol Soc. 2024 Feb;30(2):107-116. doi: 10.1017/S135561772300036X. Epub 2023 Jul 4.
Adverse childhood experiences (ACEs) have been associated with worse cognitive health in older adulthood. This study aimed to extend findings on the specificity, persistence, and pathways of associations between two ACEs and cognition by using a comprehensive neuropsychological battery and a time-lagged mediation design.
Participants were 3304 older adults in the Health and Retirement Study Harmonized Cognitive Assessment Protocol. Participants retrospectively reported whether they were exposed to parental substance abuse or experienced parental physical abuse before age 18. Factor scores derived from a battery of 13 neuropsychological tests indexed cognitive domains of episodic memory, executive functioning, processing speed, language, and visuospatial function. Structural equation models examined self-reported years of education and stroke as mediators, controlling for sociodemographics and childhood socioeconomic status.
Parental substance abuse in childhood was associated with worse later-life cognitive function across all domains, in part via pathways involving educational attainment and stroke. Parental physical abuse was associated with worse cognitive outcomes via stroke independent of education.
This national longitudinal study in the United States provides evidence for broad and persistent indirect associations between two ACEs and cognitive aging via differential pathways involving educational attainment and stroke. Future research should examine additional ACEs and mechanisms as well as moderators of these associations to better understand points of intervention.
童年逆境经历（ACEs）与老年人认知健康状况较差有关。本研究旨在通过使用全面的神经心理学测试和时间滞后的中介设计，扩展关于两种 ACEs 与认知之间的特异性、持续性和关联途径的发现。
参与者为健康与退休研究协调认知评估方案中的 3304 名老年人。参与者回顾性报告他们在 18 岁之前是否经历过父母的药物滥用或身体虐待。从 13 项神经心理学测试组成的测试组合中得出的因子分数，可索引出情景记忆、执行功能、处理速度、语言和视空间功能等认知领域。结构方程模型检验了自我报告的受教育年限和中风作为中介的作用，同时控制了社会人口统计学和儿童社会经济地位。
童年时期父母的药物滥用与所有领域的晚年认知功能较差有关，部分途径涉及受教育程度和中风。父母的身体虐待与认知结果较差有关，与教育无关，而是与中风有关。
这项在美国进行的全国性纵向研究提供了证据，证明两种 ACEs 通过涉及教育程度和中风的不同途径与认知衰老之间存在广泛而持久的间接关联。未来的研究应进一步研究其他 ACEs 和机制以及这些关联的调节剂，以更好地理解干预点。
