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Are Adverse Childhood Experiences Associated with Worse Cognitive Function in Older Adults?

Published online by Cambridge University Press:  19 November 2021

Amy B. Halpin
Affiliation:
The Department of Psychology, University of Maine, Orono, Maine, USA
Rebecca K. MacAulay*
Affiliation:
The Department of Psychology, University of Maine, Orono, Maine, USA
Angelica R. Boeve
Affiliation:
The Department of Psychology, University of Maine, Orono, Maine, USA
Lisa M. D’Errico
Affiliation:
The Department of Psychology, University of Maine, Orono, Maine, USA
Sahvannah Michaud
Affiliation:
The Department of Psychology, University of Maine, Orono, Maine, USA
*
*Correspondence and reprint requests to: Rebecca MacAulay, Department of Psychology, 301 Little Hall, Orono, Maine, 04469, USA. Fax: +1 207-581-6128; Email: [email protected]

Abstract

Objectives:

Adverse childhood experiences (ACE) are associated with an increased risk for dementia, but this relationship and modifying factors are poorly understood. This study is the first to our knowledge to comprehensively examine the effect of ACE on specific cognitive functions and measures associated with greater risk and resiliency to cognitive decline in independent community-dwelling older adults.

Methods:

Verbal/nonverbal intelligence, verbal memory, visual memory, and executive attention were assessed. Self-report measures examined depression, self-efficacy, and subjective cognitive concerns (SCC). The ACE questionnaire measured childhood experiences of abuse, neglect, and household dysfunction.

Results:

Over 56% of older adults reported an adverse childhood event. ACE scores were negatively associated with income and years of education and positively associated with depressive symptoms and SCC. ACE scores were a significant predictor of intellectual function and executive attention; however, these relationships were no longer significant after adjusting for education. Follow-up analyses using the PROCESS macro revealed that relationships among higher ACE scores with intellectual function and executive attention were mediated by education.

Conclusions:

Greater childhood adversity may increase vulnerability for cognitive impairment by impacting early education, socioeconomic status, and mental health. These findings have clinical implications for enhancing levels of cognitive reserve and addressing modifiable risk factors to prevent or attenuate cognitive decline in older adults.

Type
Research Article
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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References

REFERENCES

Almquist, Y.B., & Brännström, L. (2018). Childhood adversity and trajectories of disadvantage through adulthood: Findings from the Stockholm birth cohort study. Social Indicators Research, 136(1), 225245.CrossRefGoogle ScholarPubMed
Ancelin, M.L., Carrière, I., Artero, S., Maller, J.J., Meslin, C., Dupuy, A.M., … & Chaudieu, I. (2021). Structural brain alterations in older adults exposed to early-life adversity. Psychoneuroendocrinology, 129, 105272.CrossRefGoogle ScholarPubMed
Barnes, L.L., Wilson, R.S., Everson-Rose, S.A., Hayward, M.D., Evans, D.A., & De Leon, C.F.M. (2012). Effects of early-life adversity on cognitive decline in older African Americans and whites. Neurology, 79(24), 23212327.CrossRefGoogle ScholarPubMed
Baron, R.M. & Kenny, D.A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173.CrossRefGoogle ScholarPubMed
Benedict, R.H. (1997). Brief Visuospatial Memory Test-Revised (BVMT-R). Lutz, FL: PAR.Google Scholar
Boyle, P.A., Buchman, A.S., Wilson, R.S., Yu, L., Schneider, J.A., & Bennett, D.A. (2012). Effect of purpose in life on the relation between Alzheimer disease pathologic changes on cognitive function in advanced age. Archives of General Psychiatry, 69(5), 499504.Google ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. New York, NY: Routledge Academic.Google Scholar
Colich, N.L., Rosen, M.L., Williams, E.S., & McLaughlin, K.A. (2020). Biological aging in childhood and adolescence following experiences of threat and deprivation: A systematic review and meta-analysis. Psychological Bulletin, 146(9), 721.CrossRefGoogle ScholarPubMed
Crowe, M., Clay, O.J., Martin, R.C., Howard, V.J., Wadley, V.G., Sawyer, P., & Allman, R.M. (2013). Indicators of childhood quality of education in relation to cognitive function in older adulthood. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 68(2), 198204.CrossRefGoogle ScholarPubMed
Danese, A., Moffitt, T.E., Harrington, H., Milne, B.J., Polanczyk, G., Pariante, C.M., … & Caspi, A. (2009). Adverse childhood experiences and adult risk factors for age-related disease: Depression, inflammation, and clustering of metabolic risk markers. Archives of Pediatrics & Adolescent Medicine, 163(12), 11351143. doi: 10.1001/archpediatrics.2009.214.CrossRefGoogle ScholarPubMed
Deary, I.J., Spinath, F.M., & Bates, T.C. (2006). Genetics of intelligence. European Journal of Human Genetics, 14(6), 690700.CrossRefGoogle ScholarPubMed
Dube, S.R., Felitti, V.J., Dong, M., Giles, W.H., & Anda, R.F. (2003). The impact of adverse childhood experiences on health problems: Evidence from four birth cohorts dating back to 1900. Preventive Medicine, 37(3), 268277. doi: 10.1016/S0091-7435(03)00123-3.CrossRefGoogle ScholarPubMed
Dunn, E.C., Busso, D.S., Raffeld, M.R., Smoller, J.W., Nelson, C.A., Doyle, A.E., & Luk, G. (2016). Does developmental timing of exposure to child maltreatment predict memory performance in adulthood? Results from a large, population-based sample. Child Abuse & Neglect, 51, 181191.CrossRefGoogle ScholarPubMed
Dunn, L.M. & Dunn, D.M. (2007). PPVT-4: Peabody Picture Vocabulary Test. Minneapolis, MN: Pearson Assessments.Google Scholar
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 11491160.CrossRefGoogle ScholarPubMed
Feeney, J., Kamiya, Y., Robertson, I.H., & Kenny, R.A. (2013). Cognitive function is preserved in older adults with a reported history of childhood sexual abuse. Journal of Traumatic Stress, 26(6), 735743. doi: 10.1002/jts.21861.CrossRefGoogle ScholarPubMed
Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., … & Marks, J.S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 56(6), 774786. doi: 10.1016/j.amepre.2019.04.001.CrossRefGoogle Scholar
Font, S.A. & Maguire-Jack, K. (2016). Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions. Child Abuse & Neglect, 51, 390399.CrossRefGoogle ScholarPubMed
Geoffroy, M.C., Pereira, S.P., Li, L., & Power, C. (2016). Child neglect and maltreatment and childhood-to-adulthood cognition and mental health in a prospective birth cohort. Journal of the American Academy of Child & Adolescent Psychiatry, 55(1), 3340.CrossRefGoogle Scholar
Gershon, R.C., Wagster, M.V., Hendrie, H.C., Fox, N.A., Cook, K.F., & Nowinski, C.J. (2013). NIH toolbox for assessment of neurological and behavioral function. Neurology, 80(11 Supplement 3), S2S6. doi: 10.1212/WNL.0b013e3182872e5f.CrossRefGoogle ScholarPubMed
Gould, F., Clarke, J., Heim, C., Harvey, P.D., Majer, M., & Nemeroff, C.B. (2012). The effects of child abuse and neglect on cognitive functioning in adulthood. Journal of Psychiatric Research, 46(4), 500506. doi: 10.1016/j.jpsychires.2012.01.005.CrossRefGoogle ScholarPubMed
Hart, H. & Rubia, K. (2012). Neuroimaging of child abuse: a critical review. Frontiers in Human Neuroscience, 6, 52. doi: 10.3389/fnhum.2012.00052 CrossRefGoogle ScholarPubMed
Hayes, A.F. (2017). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York, NY: Guilford Publications.Google Scholar
Heaton, R.K., Akshoomoff, N., Tulsky, D., Mungas, D., Weintraub, S., Dikmen, S., … & Gershon, R. (2014). Reliability and validity of composite scores from the NIH Toolbox Cognition Battery in adults. Journal of the international Neuropsychological Society: JINS, 20(6), 588.CrossRefGoogle ScholarPubMed
House, J.S., Lantz, P.M., & Herd, P. (2005). Continuity and change in the social stratification of aging and health over the life course: evidence from a nationally representative longitudinal study from 1986 to 2001/2002 (Americans’ Changing Lives Study). The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60(Special_Issue_2), S15S26.CrossRefGoogle Scholar
Jessen, F., Amariglio, R.E., Van Boxtel, M., Breteler, M., Ceccaldi, M., Chételat, G., … & Glodzik, L. (2014). A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease. Alzheimer’s & Dementia, 10(6), 844852. doi: 10.1016/j.jalz.2014.01.001.CrossRefGoogle ScholarPubMed
Kim, J.J. & Diamond, D.M. (2002). The stressed hippocampus, synaptic plasticity and lost memories. Nature Reviews Neuroscience, 3(6), 453. doi: 10.1038/nrn849.CrossRefGoogle ScholarPubMed
Kobayashi, L.C., Farrell, M.T., Payne, C.F., Mall, S., Montana, L., Wagner, R.G., … & Berkman, L.F. (2020). Adverse childhood experiences and domain-specific cognitive function in a population-based study of older adults in rural South Africa. Psychology and Aging, 35(6), 818.CrossRefGoogle Scholar
Korten, N.C., Penninx, B.W., Pot, A.M., Deeg, D.J., & Comijs, H.C. (2014). Adverse childhood and recent negative life events: contrasting associations with cognitive decline in older persons. Journal of Geriatric Psychiatry and Neurology, 27(2), 128138. doi: 10.1177/0891988714522696.CrossRefGoogle ScholarPubMed
Lansford, J.E., Dodge, K.A., Pettit, G.S., Bates, J.E., Crozier, J., & Kaplow, J. (2002). A 12-year prospective study of the long-term effects of early child physical maltreatment on psychological, behavioral, and academic problems in adolescence. Archives of Pediatrics & Adolescent Medicine, 156(8), 824830. doi: 10.1001/archpedi.156.8.824.CrossRefGoogle ScholarPubMed
Luecken, L.J. (2006). Early family adversity and cognitive performance in aging: a lifespan developmental model. Journal of Social and Clinical Psychology, 25(1), 3352. doi: 10.1521/jscp.2006.25.1.33.CrossRefGoogle Scholar
Lupien, S.J., McEwen, B.S., Gunnar, M.R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience, 10(6), 434. doi: 10.1038/nrn2639.CrossRefGoogle ScholarPubMed
MacAulay, R.K., Halpin, A., Cohen, A.S., Calamia, M., Boeve, A., Zhang, L., … & Keller, J.N. (2020). Predictors of heterogeneity in cognitive function: APOE-e4, sex, education, depression, and vascular risk. Archives of Clinical Neuropsychology. doi: 10.1093/arclin/acaa014.CrossRefGoogle ScholarPubMed
Majer, M., Nater, U.M., Lin, J.M.S., Capuron, L., & Reeves, W.C. (2010). Association of childhood trauma with cognitive function in healthy adults: a pilot study. BMC Neurology, 10(1), 61. doi: 10.1186/1471-2377-10-61.CrossRefGoogle ScholarPubMed
Marden, J.R., Tchetgen Tchetgen, E.J., Kawachi, I., & Glymour, M.M. (2017). Contribution of socioeconomic status at 3 life-course periods to late-life memory function and decline: early and late predictors of dementia risk. American Journal of Epidemiology, 186(7), 805814. doi: 10.1093/aje/kwx155.CrossRefGoogle ScholarPubMed
McLaughlin, K.A., DeCross, S.N., Jovanovic, T., & Tottenham, N. (2019). Mechanisms linking childhood adversity with psychopathology: Learning as an intervention target. Behaviour Research and Therapy, 118, 101109.CrossRefGoogle ScholarPubMed
McLaughlin, K.A. & Sheridan, M.A. (2016). Beyond cumulative risk: A dimensional approach to childhood adversity. Current Directions in Psychological Science, 25(4), 239245.CrossRefGoogle ScholarPubMed
Mendonça, M.D., Alves, L., & Bugalho, P. (2016). From subjective cognitive complaints to dementia: who is at risk?: A systematic review. American Journal of Alzheimer’s Disease & Other Dementias, 31(2), 105114.CrossRefGoogle ScholarPubMed
Merrick, M.T., Ford, D.C., Ports, K.A., Guinn, A.S., Chen, J., Klevens, J., … & Mercy, J.A. (2019). Vital signs: estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention—25 states, 2015–2017. Morbidity and Mortality Weekly Report, 68(44), 999.CrossRefGoogle ScholarPubMed
Morris, J.C., Weintraub, S., Chui, H.C., Cummings, J., DeCarli, C., Ferris, S., … & Beekly, D. (2006). The Uniform Data Set (UDS): clinical and cognitive variables and descriptive data from Alzheimer Disease Centers. Alzheimer Disease & Associated Disorders, 20(4), 210216. doi: 10.1097/01.wad.0000213865.09806.92.CrossRefGoogle ScholarPubMed
Nasreddine, Z.S., Phillips, N.A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., … & Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695699. doi: 10.1111/j.1532-5415.2005.53221.x.CrossRefGoogle ScholarPubMed
National Heart, Lung, Blood Institute, National Institute of Diabetes, Digestive, & Kidney Diseases. (2013). Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Scotts Valley, CA: CreateSpace Independent Publishing Platform.Google Scholar
National Institute of Neurological Disorders and Stroke (NINDS). (2015). User Manual for the Quality of Life in Neurological Disorders (Neuro-QoL) Measures, Version 2.0, March 2015. Retrieved from http://www.healthmeasures.net/images/neuro_qol/NeuroQOL_User_Manual_v2_24Mar2015.pdf Google Scholar
Nikulina, V. & Widom, C.S. (2013). Child maltreatment and executive functioning in middle adulthood: A prospective examination. Neuropsychology, 27(4), 417.CrossRefGoogle ScholarPubMed
Nolin, P. & Ethier, L. (2007). Using neuropsychological profiles to classify neglected children with or without physical abuse. Child Abuse & Neglect, 31(6), 631643. doi: 10.1016/j.chiabu.2006.12.009.CrossRefGoogle ScholarPubMed
Pechtel, P. & Pizzagalli, D.A. (2011). Effects of early life stress on cognitive and affective function: An integrated review of human literature. Psychopharmacology, 214(1), 5570. doi: 10.1007/s00213-010-2009-2.CrossRefGoogle ScholarPubMed
Perneger, T.V. (1998). What’s wrong with Bonferroni adjustments. BMJ, 316(7139), 12361238.CrossRefGoogle ScholarPubMed
Petkus, A.J., Lenze, E.J., Butters, M.A., Twamley, E.W., & Wetherell, J.L. (2018). Childhood trauma is associated with poorer cognitive performance in older adults. The Journal of Clinical Psychiatry, 79(1), 120.CrossRefGoogle ScholarPubMed
Rabin, L.A., Smart, C.M., & Amariglio, R.E. (2017). Subjective cognitive decline in preclinical Alzheimer’s disease. Annual Review of Clinical Psychology, 13, 369396. doi: 10.1146/annurev-clinpsy-032816-045136.CrossRefGoogle ScholarPubMed
Rao, U., Chen, L.A., Bidesi, A.S., Shad, M.U., Thomas, M.A., & Hammen, C.L. (2010). Hippocampal changes associated with early-life adversity and vulnerability to depression. Biological Psychiatry, 67(4), 357364. doi: 10.1016/j.biopsych.2009.10.017.CrossRefGoogle ScholarPubMed
Reitan, R.M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills, 8(3), 271276.CrossRefGoogle Scholar
Ritchie, K., Jaussent, I., Stewart, R., Dupuy, A.M., Courtet, P., Malafosse, A., & Ancelin, M.L. (2011). Adverse childhood environment and late-life cognitive functioning. International Journal of Geriatric Psychiatry, 26(5), 503510. doi: 10.1002/gps.2553.CrossRefGoogle ScholarPubMed
Salthouse, T.A. (2010). Selective review of cognitive aging. Journal of the International Neuropsychological Society, 16(5), 754760.CrossRefGoogle ScholarPubMed
Schmidt, M. (1996). Rey Auditory Verbal Learning Test: A Handbook (p. 1996). Los Angeles, CA: Western Psychological Services.Google Scholar
Schwartz, J.A., Wright, E.M., & Valgardson, B.A. (2019). Adverse childhood experiences and deleterious outcomes in adulthood: A consideration of the simultaneous role of genetic and environmental influences in two independent samples from the United States. Child Abuse & Neglect, 88, 420431.CrossRefGoogle ScholarPubMed
Scott, E.P., Sorrell, A., & Benitez, A. (2019). Psychometric properties of the NIH toolbox cognition battery in healthy older adults: Reliability, validity, and agreement with standard neuropsychological tests. Journal of the International Neuropsychological Society, 25(8), 857867.CrossRefGoogle ScholarPubMed
Sheikh, J.I. & Yesavage, J.A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist: The Journal of Aging and Mental Health. doi: 10.1300/J018v05n01_09.Google Scholar
Sheridan, M.A., Peverill, M., Finn, A.S., & McLaughlin, K.A. (2017). Dimensions of childhood adversity have distinct associations with neural systems underlying executive functioning. Development and Psychopathology, 29(5), 17771794.CrossRefGoogle ScholarPubMed
Soloman, S.R. & Sawilowsky, S.S. (2009). Impact of rank-based normalizing transformations on the accuracy of test scores. Journal of Modern Applied Statistical Methods, 8(2), 9.CrossRefGoogle Scholar
Stern, Y. (2006). Cognitive reserve and Alzheimer disease. Alzheimer Disease & Associated Disorders, 20(2), 112117.CrossRefGoogle ScholarPubMed
Taylor, S.E., Way, B.M., & Seeman, T.E. (2011). Early adversity and adult health outcomes. Development and Psychopathology, 23(3), 939954.CrossRefGoogle ScholarPubMed
Teicher, M.H., Samson, J.A., Anderson, C.M., & Ohashi, K. (2016). The effects of childhood maltreatment on brain structure, function and connectivity. Nature Reviews Neuroscience, 17(10), 652666.CrossRefGoogle ScholarPubMed
Toyoshima, K., Inoue, T., Masuya, J., Fujimura, Y., Higashi, S., Tanabe, H., & Kusumi, I. (2020). Structural equation modeling approach to explore the influence of childhood maltreatment in adults. PLoS One, 15(10), e0239820.CrossRefGoogle ScholarPubMed
Turecki, G., Ota, V.K., Belangero, S.I., Jackowski, A., & Kaufman, J. (2014). Early life adversity, genomic plasticity, and psychopathology. The Lancet Psychiatry, 1(6), 461466.CrossRefGoogle Scholar
U.S. Census Bureau. (2018). QuickFacts Maine. Retrieved June 6, 2019 from https://www.census.gov/quickfacts/ME.Google Scholar
Vasilevski, V. & Tucker, A. (2016). Wide-ranging cognitive deficits in adolescents following early life maltreatment. Neuropsychology, 30(2), 239. doi: 10.1037/neu0000215.CrossRefGoogle ScholarPubMed
Wechsler, D. (2008). Wechsler Adult Intelligence Scale–Fourth Edition (WAIS–IV). San Antonio, TX: Pearson Assessments.Google Scholar
Weintraub, S., Dikmen, S.S., Heaton, R.K., Tulsky, D.S., Zelazo, P.D., Slotkin, J., … & Havlik, R. (2014). The cognition battery of the NIH toolbox for assessment of neurological and behavioral function: Validation in an adult sample. Journal of the International Neuropsychological Society: JINS, 20(6), 567.CrossRefGoogle Scholar
Wilkinson, G.S. & Robertson, G.J. (2006). Wide Range Achievement Test (WRAT4). Lutz, FL: PAR.Google Scholar