Childhood Maltreatment and Dementia Risk Factors in Midlife: A Prospective Investigation.

Cathy S Widom, Hang H Do, Kristin S Lynch, Jennifer J Manly
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Abstract

Background: Previous studies have linked childhood adversities to dementia risk, yet most studies are cross-sectional in design and utilize retrospective self-reports to assess childhood experiences. These design characteristics make it difficult to establish temporal order and draw firm conclusions.

Objectives: Using a longitudinal design, we sought to determine whether childhood maltreatment predicts dementia risk factors in middle adulthood.

Methods: Data have been obtained from a prospective cohort design study of children with documented cases of childhood maltreatment (ages 0-11 years at case identification) and demographically matched controls who were followed up and interviewed in middle adulthood. Outcomes were assessed through a medical examination and interview, and 807 of the cases that included blood collection at mean age 41. Dementia risk were investigated using 11 potentially modifiable risk factors.

Results: Compared to controls, individuals with histories of childhood maltreatment had a higher risk of low educational attainment, low social contact, smoking, and clinical depression, and a higher total number of dementia risk factors. In general, childhood maltreatment predicted a higher risk of dementia for females, males, and Black and White participants. Black maltreated participants had a greater risk for traumatic brain injury compared to Black controls. Physical abuse, sexual abuse, and neglect, each predicted a higher number of dementia risk factors in mid-life.

Conclusion: These findings provide evidence that childhood maltreatment increases the risk for dementia in mid-life and has a demonstrable impact lasting over 30 years. Reducing the prevalence of mid-life dementia risk factors could reduce the risk of later-life dementia.

童年虐待与中年痴呆症风险因素:一项前瞻性调查
背景:以往的研究将童年逆境与痴呆症风险联系在一起,但大多数研究都是横断面设计,并利用回顾性自我报告来评估童年经历。这些设计特点使得研究难以确定时间顺序并得出确切结论:我们采用纵向设计,试图确定童年虐待是否会预测中年痴呆症的风险因素:方法:我们从一项前瞻性队列设计研究中获得了数据,研究对象是有记录的儿童虐待病例(病例确定时年龄为 0-11 岁)和人口统计学上匹配的对照组,这些对照组在成年中期接受了随访和访谈。研究结果通过体检和访谈进行评估,其中807例病例在平均41岁时进行了采血,并利用11个潜在的可改变风险因素对痴呆症风险进行了调查:与对照组相比,有童年虐待史的人受教育程度低、社会接触少、吸烟和临床抑郁的风险更高,痴呆症风险因素的总数也更高。一般来说,女性、男性、黑人和白人受虐者患痴呆症的风险都较高。与黑人对照组相比,受过虐待的黑人参与者发生脑外伤的风险更高。身体虐待、性虐待和忽视都会增加中年痴呆症的风险因素:这些研究结果提供了证据,表明童年虐待会增加中年痴呆症的风险,并且会产生持续 30 多年的明显影响。降低中年痴呆症风险因素的发生率可以降低晚年痴呆症的风险。
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