School of Nursing (MZ), University of Wisconsin-Madison, Madison, WI; Alzheimer's Disease Research Center (MZ), University of Wisconsin-Madison, Madison, WI.
Institute for Social Research (AS), University of Michigan, Ann Arbor, MI.
Am J Geriatr Psychiatry. 2024 Mar;32(3):373-385. doi: 10.1016/j.jagp.2023.09.015. Epub 2023 Oct 26.
Sociocontextual factors powerfully shape risk for age-related cognitive impairment, including excess risk burdening medically underserved populations. Lifecourse adversity associates with cognitive aging, but harms are likely mitigable. Understanding population-salient relationships and sensitive periods for exposure is crucial for targeting clinical interventions.
The authors examined childhood and adulthood traumatic events in relation to cognition among Black and White older adults in the Health and Retirement Study (HRS).
Participants (N = 13,952) aged 55+ had complete lifetime trauma and cognitive testing data at the 2006/08, 2010/12, and/or 2014/16 waves.
Trauma indices comprised childhood and adulthood event counts. Outcomes included baseline performance and trajectories on the Telephone Interview for Cognitive Status.
Main and nonlinear trauma effects were modeled via linear regression, and overall contributions assessed with omnibus likelihood ratio tests.
Black participants (N = 2,345) reported marginally lower adulthood trauma exposure than White participants (N = 11,607) with no other exposure differentials observed. In White participants only, greater childhood trauma exposure predicted worse baseline cognition but slower change over time. Across race, adulthood trauma robustly associated with baseline cognition. Relationships were frequently nonlinear: low but nonzero trauma predicted highest cognitive scores, with much poorer cognition observed as trauma exposure increased. Relationships between adulthood trauma and trajectory were limited to the White sample.
Traumatic experiences, particularly in adulthood, may impact late-life cognitive health if not addressed. Findings highlight foci for clinical researchers and providers: adverse life events as a source of cognitive risk, and identification of community-specific resources that buffer behavioral, physical, and mental health sequelae of previous and incident trauma.
社会文化因素强烈影响与年龄相关的认知障碍风险，包括使医疗服务不足的人群面临过高风险。生命历程逆境与认知衰老有关，但危害可能是可以减轻的。了解与人口相关的重要关系和暴露的敏感时期对于针对临床干预至关重要。
作者研究了黑人和白人老年人群体在健康与退休研究（HRS）中童年和成年期创伤事件与认知之间的关系。
年龄在 55 岁及以上的参与者（N=13952）在 2006/08、2010/12 和/或 2014/16 波次具有完整的终生创伤和认知测试数据。
创伤指数包括童年和成年期事件计数。结果包括基线表现和电话认知状态测试的轨迹。
通过线性回归对主要和非线性创伤效应进行建模，并通过总似然比检验评估总体贡献。
黑人参与者（N=2345）报告的成年期创伤暴露略低于白人参与者（N=11607），但没有观察到其他暴露差异。仅在白人参与者中，更多的童年创伤暴露预测了较差的基线认知，但随着时间的推移变化较慢。在整个种族中，成年期创伤与基线认知密切相关。这些关系经常是非线性的：低但非零的创伤预示着最高的认知分数，随着创伤暴露的增加，认知能力明显下降。成年期创伤与轨迹之间的关系仅限于白人样本。
如果不加以解决，创伤经历，特别是成年期的创伤经历，可能会影响晚年的认知健康。研究结果强调了临床研究人员和提供者的重点：作为认知风险来源的不良生活事件，以及确定特定社区的资源，这些资源可以缓冲以前和新发生的创伤的行为、身体和心理健康后果。
