Department of Psychology, John Jay College, City University of New York, 529 West 59th Street, New York City, NY, 10019, USA.
Gertrude H. Sergievsky Center and the Taub Institute for Research in Aging and Alzheimer's disease, Columbia University, 710 W 168th St, New York, NY10032, USA.
Curr Alzheimer Res. 2023;20(9):636-647. doi: 10.2174/0115672050281539231222071355.
Previous studies have linked childhood adversities to dementia risk, yet most studies are cross-sectional in design and utilize retrospective self-reports to assess childhood experiences. These design characteristics make it difficult to establish temporal order and draw firm conclusions.
Using a longitudinal design, we sought to determine whether childhood maltreatment predicts dementia risk factors in middle adulthood.
Data have been obtained from a prospective cohort design study of children with documented cases of childhood maltreatment (ages 0-11 years at case identification) and demographically matched controls who were followed up and interviewed in middle adulthood. Outcomes were assessed through a medical examination and interview, and 807 of the cases that included blood collection at mean age 41. Dementia risk were investigated using 11 potentially modifiable risk factors.
Compared to controls, individuals with histories of childhood maltreatment had a higher risk of low educational attainment, low social contact, smoking, and clinical depression, and a higher total number of dementia risk factors. In general, childhood maltreatment predicted a higher risk of dementia for females, males, and Black and White participants. Black maltreated participants had a greater risk for traumatic brain injury compared to Black controls. Physical abuse, sexual abuse, and neglect, each predicted a higher number of dementia risk factors in mid-life.
These findings provide evidence that childhood maltreatment increases the risk for dementia in mid-life and has a demonstrable impact lasting over 30 years. Reducing the prevalence of mid-life dementia risk factors could reduce the risk of later-life dementia.
先前的研究将儿童期逆境与痴呆风险联系起来，但大多数研究都是横断面设计，并利用回顾性自我报告来评估儿童时期的经历。这些设计特征使得很难确定时间顺序并得出确凿的结论。
本研究采用纵向设计，旨在确定儿童期虐待是否预测中年期痴呆风险因素。
本研究的数据来自一项前瞻性队列设计研究，研究对象为有儿童期虐待记录的儿童（在病例识别时年龄为 0-11 岁）和在中年期接受随访和访谈的在人口统计学上匹配的对照者。通过体格检查和访谈评估结局，其中 807 例病例在平均年龄 41 岁时采集了血液。通过 11 种潜在可改变的风险因素来研究痴呆风险。
与对照组相比，有儿童期虐待史的个体受教育程度较低、社会接触较少、吸烟和临床抑郁的风险较高，且痴呆风险因素的总数较高。总体而言，儿童期虐待对女性、男性以及黑人和白人参与者的痴呆风险更高。与黑人对照组相比，遭受过虐待的黑人参与者发生创伤性脑损伤的风险更高。身体虐待、性虐待和忽视，每种情况都在中年期预测了更多的痴呆风险因素。
这些发现提供了证据表明，儿童期虐待会增加中年期痴呆的风险，并且具有持续 30 多年的可证明影响。减少中年期痴呆风险因素的患病率可能会降低晚年痴呆的风险。
