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中年及老年人群中童年不良经历与认知功能轨迹的纵向关联:基于群组的轨迹建模

Longitudinal association of adverse childhood experiences with cognitive function trajectories among middle-aged and older adults: group-based trajectory modeling.

作者信息

He Xingyue, Yang Hui

机构信息

School of Nursing, Shanxi Medical University, Taiyuan, China.

Department of Nursing, The First Hospital of Shanxi Medical University, Taiyuan, China.

出版信息

Front Psychiatry. 2024 Aug 6;15:1440265. doi: 10.3389/fpsyt.2024.1440265. eCollection 2024.

Abstract

INTRODUCTION

Adverse childhood experiences (ACEs) impact cognitive function, but the relationship remains unclear. We aim to identify cognitive function trajectories and scrutinize the correlation between ACEs and cognitive function.

METHODS

To identify cognitive trajectories, we employed a group-based trajectory model, and influential factors were determined using multinomial unordered logistic regression analysis.

RESULTS

Three cognitive decline subgroups emerged: low-start decline, high-start stability, and mid-start decline. There is no dose-response relationship between cumulative adverse childhood experiences and cognitive function. The high-start stability group had specific residence and education traits, while sibling death affected them. The mid-start decline group was vulnerable to parental death, physical abuse, and domestic violence. The low-start decline group should consider age structure and childhood friendships.

CONCLUSIONS

No dose-response association between cumulative ACEs and cognitive decline. Still, specific ACE metrics are correlated with cognitive trajectories. We can incorporate patients' ACEs into cognitive function assessments for early risk factor identification and tailored interventions. Moreover, recognizing the influence of early-life experiences on cognitive function, we can advocate for nurturing positive family and societal environments to optimize cognitive function.

摘要

引言

童年不良经历(ACEs)会影响认知功能,但二者关系尚不明晰。我们旨在确定认知功能轨迹,并审视ACEs与认知功能之间的相关性。

方法

为确定认知轨迹,我们采用了基于群体的轨迹模型,并使用多项无序逻辑回归分析来确定影响因素。

结果

出现了三个认知衰退亚组:低起始衰退组、高起始稳定组和中起始衰退组。童年累积不良经历与认知功能之间不存在剂量反应关系。高起始稳定组具有特定的居住和教育特征,而兄弟姐妹死亡对其有影响。中起始衰退组易受父母死亡、身体虐待和家庭暴力影响。低起始衰退组应考虑年龄结构和童年友谊。

结论

累积ACEs与认知衰退之间不存在剂量反应关联。不过,特定的ACE指标与认知轨迹相关。我们可以将患者的ACEs纳入认知功能评估中,以早期识别风险因素并进行针对性干预。此外,认识到早期生活经历对认知功能的影响,我们可以倡导营造积极的家庭和社会环境,以优化认知功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80dd/11333235/18f9f4d0a8f8/fpsyt-15-1440265-g001.jpg

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