The mediating role of life course cognitive reserve-enhancing factors in the relationship between adverse childhood experiences and dementia among older adults: evidence from a prospective cohort study in the United States.
{"title":"The mediating role of life course cognitive reserve-enhancing factors in the relationship between adverse childhood experiences and dementia among older adults: evidence from a prospective cohort study in the United States.","authors":"Guangwen Liu, Tianhao Bao, Changqing Gao, Chenlu Hong, Boyuan Guan, Yujie Huang, Xiaoying Zheng, Yanan Luo","doi":"10.1007/s00127-024-02800-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To explore the relationship between adverse childhood experiences (ACEs) and incident dementia, and examine the mediating effect of cognitive reserve-enhancing factors from life course perspective. Further, we verified the heterogeneities of associations of ACEs, enhancing factors, and dementia by dementia genetic risk.</p><p><strong>Methods: </strong>Data was from the US Health and Retirement Study, involving 51,327 observations (50+) with a 10-year follow-up. Dementia was determined by the modified Telephone Interview for Cognitive Status. Six ACEs were assessed from two dimensions namely financial adversity and childhood trauma. Cognitive reserve-enhancing factors were rated during three periods of life-course, namely early-life stage (educational attainment,), adulthood (household income) and late-life stage (weekly physical activity). Genetic risk was evaluated by polygenic risk score for Alzheimer's disease. Cox regression models were conducted to examine the association between ACEs and dementia risk where ACEs were deemed as a continuous variable. \"Mediation\" package in R was used to test the mediating effect. Subgroup analysis was conducted to verify the heterogeneity of dementia genetic risk.</p><p><strong>Results: </strong>Participants with one additional number of ACEs was associated with increased risk of dementia (HR = 1.08, 95% CI: 1.02, 1.16). The correlation of the number of ACEs and dementia was fully mediated by early-life stage enhancing factor and partially mediated by adulthood enhancing factor. The above mediating roles only exist among those with moderate and high dementia genetic risk.</p><p><strong>Conclusion: </strong>Exposure to a larger number of ACEs is significantly linked to dementia, and cognitive reserve-enhancing factors might mediate this association. Early interventions on the adverse life condition and emphasis on older adults with moderate and high genetic dementia risk were recommended.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Social Psychiatry and Psychiatric Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00127-024-02800-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To explore the relationship between adverse childhood experiences (ACEs) and incident dementia, and examine the mediating effect of cognitive reserve-enhancing factors from life course perspective. Further, we verified the heterogeneities of associations of ACEs, enhancing factors, and dementia by dementia genetic risk.
Methods: Data was from the US Health and Retirement Study, involving 51,327 observations (50+) with a 10-year follow-up. Dementia was determined by the modified Telephone Interview for Cognitive Status. Six ACEs were assessed from two dimensions namely financial adversity and childhood trauma. Cognitive reserve-enhancing factors were rated during three periods of life-course, namely early-life stage (educational attainment,), adulthood (household income) and late-life stage (weekly physical activity). Genetic risk was evaluated by polygenic risk score for Alzheimer's disease. Cox regression models were conducted to examine the association between ACEs and dementia risk where ACEs were deemed as a continuous variable. "Mediation" package in R was used to test the mediating effect. Subgroup analysis was conducted to verify the heterogeneity of dementia genetic risk.
Results: Participants with one additional number of ACEs was associated with increased risk of dementia (HR = 1.08, 95% CI: 1.02, 1.16). The correlation of the number of ACEs and dementia was fully mediated by early-life stage enhancing factor and partially mediated by adulthood enhancing factor. The above mediating roles only exist among those with moderate and high dementia genetic risk.
Conclusion: Exposure to a larger number of ACEs is significantly linked to dementia, and cognitive reserve-enhancing factors might mediate this association. Early interventions on the adverse life condition and emphasis on older adults with moderate and high genetic dementia risk were recommended.
期刊介绍：
Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic.
In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation.
Both original work and review articles may be submitted.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
