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未发现关联:不良童年经历与老年澳大利亚成年人认知障碍的关系。

No Association Found: Adverse Childhood Experiences and Cognitive Impairment in Older Australian Adults.

机构信息

James Lian, School of Psychology, University of New South Wales, Sydney, NSW, Australia,

出版信息

J Prev Alzheimers Dis. 2024;11(6):1818-1825. doi: 10.14283/jpad.2024.133.

Abstract

OBJECTIVE

This study aimed to investigate the relationship between childhood adversity and cognitive impairment in older adults.

METHODS

We analysed data from 1568 participants aged 72-79 (M = 75.1, SD = 1.5, % male = 52.6%) from Wave 4 of the Personality and Total Health (PATH) Through Life Project. The outcome variable was the presence of mild cognitive impairment (MCI) or dementia, determined through a clinically validated algorithmic diagnostic criteria. Childhood adversity was assessed using a 17-item scale covering various domestic adversities such as poverty, neglect, physical abuse, and verbal abuse. Adversity was operationalised using cumulative analysis, dichotomisation (<3 adversities; 3+ adversities), and latent class analysis. Multiple logistic regressions were employed to estimate the association between childhood adversity and cognitive impairment, while controlling for covariates including education, gender, ethnicity, and APOE ε4 status.

RESULTS

Our analyses revealed no significant association between childhood adversity and the presence of MCI or dementia across all tested models. Sensitivity analyses, exploring alternative scenarios, consistently failed to yield statistically significant findings.

CONCLUSION

In contrast to prevailing research findings, this study does not support a link between childhood domestic adversity and late-life cognitive outcomes. These results underscore the mixed results on adversity and cognition, highlighting the need for further research. Future investigations should consider the roles of potential mediating and protective factors within this complex relationship.

摘要

目的

本研究旨在探讨老年人童年逆境与认知障碍之间的关系。

方法

我们分析了来自人格与总体健康(PATH)终身研究项目第 4 波的 1568 名 72-79 岁参与者(M=75.1,SD=1.5,%男性=52.6%)的数据。因变量为轻度认知障碍(MCI)或痴呆,通过临床验证的算法诊断标准确定。童年逆境使用涵盖各种家庭逆境(如贫困、忽视、身体虐待和言语虐待)的 17 项量表进行评估。逆境使用累积分析、二分法(<3 逆境;3+逆境)和潜在类别分析进行操作化。采用多元逻辑回归估计童年逆境与认知障碍之间的关联,同时控制教育、性别、种族和 APOE ε4 状态等协变量。

结果

我们的分析表明,在所有测试模型中,童年逆境与 MCI 或痴呆的存在之间均无显著关联。敏感性分析探索了替代情景,也未能得出统计学上显著的发现。

结论

与流行的研究结果相反,本研究不支持童年期家庭逆境与晚年认知结果之间存在关联。这些结果突显了逆境与认知之间存在的混杂结果,强调需要进一步研究。未来的研究应考虑在这种复杂关系中潜在的中介和保护因素的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1418/11573808/2afd1f9d2c06/42414_2024_133_Fig1_HTML.jpg

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