Joshi Aishwarya, Yeo Jungwon
School of Global Health Management and Informatics, University of Central Florida, 501 W Livingston St, Orlando, FL 32801 (
University of Maryland, Baltimore County, Baltimore.
Prev Chronic Dis. 2025 Jul 17;22:E42. doi: 10.5888/pcd22.250116.
Cognitive health is influenced by a complex interplay of factors throughout the lifespan. Identifying childhood adversities and social needs can be important in mitigating subjective cognitive decline and promoting healthy aging. This study analyzes the role of social drivers of health on adverse childhood experiences and subjective cognitive decline.
We conducted structural equation modeling on data from the 2023 Behavioral Risk Factor Surveillance System to investigate the association among adverse childhood experiences, social drivers of health, and subjective cognitive decline in a sample of adults aged 45 years or older (n = 35,754).
In our study sample, 17.7% reported experiencing subjective cognitive decline within the past 12 months. Adverse childhood experiences were significantly associated with greater subjective cognitive decline (β = 0.136, P < .001). Adverse childhood experiences were negatively associated with both social drivers of health, perceived social support (β = -0.517, P < .001), and socioeconomic stability (β = -0.022, P = .047). However, greater perceived social support (β = -0.260, P < .001) and socioeconomic stability (β = -0.086, P < .001) reduced the effects of adverse childhood experiences on subjective cognitive decline.
Adverse childhood experiences were significantly associated with subjective cognitive decline; however, this association was attenuated when mediated by perceived social support and socioeconomic stability. These findings can inform public health providers and policymakers to implement targeted interventions, such as promoting resilience, reinforcing nurturing parenting styles, strengthening community networks, and integrating behavioral health into primary care settings.
认知健康在整个生命周期中受到多种因素复杂的相互作用的影响。识别童年逆境和社会需求对于减轻主观认知衰退和促进健康老龄化可能很重要。本研究分析了健康的社会驱动因素在童年不良经历和主观认知衰退中的作用。
我们对2023年行为风险因素监测系统的数据进行了结构方程建模，以调查45岁及以上成年人样本（n = 35,754）中童年不良经历、健康的社会驱动因素和主观认知衰退之间的关联。
在我们的研究样本中，17.7%的人报告在过去12个月内经历了主观认知衰退。童年不良经历与更大程度的主观认知衰退显著相关（β = 0.136，P <.001）。童年不良经历与健康的社会驱动因素、感知到的社会支持（β = -0.517，P <.001）和社会经济稳定性（β = -0.022，P =.047）均呈负相关。然而，更高的感知社会支持（β = -0.260，P <.001）和社会经济稳定性（β = -0.086，P <.001）降低了童年不良经历对主观认知衰退的影响。
童年不良经历与主观认知衰退显著相关；然而，当由感知社会支持和社会经济稳定性介导时，这种关联会减弱。这些发现可为公共卫生提供者和政策制定者提供信息，以实施有针对性的干预措施，如提高恢复力、强化养育方式、加强社区网络以及将行为健康纳入初级保健环境。
