The association between adverse childhood events and later-life cognitive function and dementia risk

Abstract

Background: Considerable work exists in the literature to describe the negative impacts of early-life stress exposures on health in adulthood. This study investigated whether the accumulation of adverse childhood events is associated with later-life cognitive function and incident dementia. Methods: Participants were 1562 community-dwelling older adults, who were enrolled in the ESPRIT cohort in France. Adverse childhood events were measured using a modified version of the Childhood Trauma Questionnaire. Cognition was measured using tests of global cognition, visual memory, verbal fluency, psychomotor speed and executive function. Fourteen-year incident dementia was diagnosed using DSM-IV criteria. Results: In comparison to participants with two or less adverse childhood events, increased risk of poor psychomotor speed at baseline was observed in individuals with multiple adverse childhood events (3–4 events OR: 1.39, 95% CI: 1.00–1.93); ≥5 events (OR: 1.52, 95% CI: 1.07–2.17), particularly in women but not in men. Worse verbal fluency was also observed in individuals who experienced between three and four adverse childhood events (OR: 1.34, 95% CI: 1.00–1.78). Amongst the individual factors investigated, early-life abuse/maltreatment (OR: 1.47, 95% CI: 1.02–2.14) and poverty/financial difficulties (OR: 1.53, 95% CI: 1.12–2.08) was associated with worse psychomotor speed. No associations were observed with incident dementia. Limitations: Participants most at risk (those with baseline dementia) were excluded. Conclusion: Multiple adverse childhood events are associated with worse psychomotor speed, and verbal fluency in later-life, however further research is needed to determine the mechanisms underlying this association and whether it results from unmeasured confounding, including social disadvantage.