童年不良经历与晚年认知的种族差异之间的关联机制。

IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY
Sydney R Wilhoite, Afsara B Zaheed, Jordan D Palms, Emily P Morris, Ketlyne Sol, Alexa Martino, Laura B Zahodne
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引用次数: 0

摘要

目的:童年不良经历(ACEs)可能是痴呆症等晚年认知障碍的一个风险因素;然而,很少有研究在健康差异框架下对其潜在机制(如心血管健康和抑郁症状)进行调查:方法:密歇根认知老龄化项目的 418 名 55 岁以上居住在社区的成年人(50% 为非西班牙裔黑人,50% 为非西班牙裔白人)回顾性报告了 9 项 ACE。基线总体认知度是综合神经心理学电池中五个因子得分的 z 值复合值。抑郁症状采用流行病学研究中心抑郁量表进行评估。心血管健康通过收缩压进行操作。一个控制社会人口统计学、儿童健康和儿童社会经济地位的中介模型估计了ACE通过抑郁症状和血压对整体认知的间接影响。种族差异通过 t 检验和分层模型进行检验:通过抑郁症状[β=-.040,95% CI (-.067,-.017)],观察到ACE对认知的负向间接影响,但对整个样本的血压没有影响。与白人参与者相比,黑人参与者报告了更多的 ACE(Cohen's d = .21),报告了更多的抑郁症状(Cohen's d = .35),血压更高(Cohen's d = .41),认知分数更低(Cohen's d = 1.35)。在分层模型中,黑人参与者的抑郁症状产生了负的间接效应[β = -.074, 95% CI (-.128, -.029)] ,而白人参与者则没有:这些结果凸显了在整个生命过程中考虑种族模式背景因素的必要性。这些因素可能会加剧 ACE 的负面影响和相关的心理健康后果,并导致认知老化方面的种族差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mechanisms underlying the association between adverse childhood experiences and racial disparities in later-life cognition.

Objective: Adverse childhood experiences (ACEs) may be a risk factor for later-life cognitive disorders such as dementia; however, few studies have investigated underlying mechanisms, such as cardiovascular health and depressive symptoms, in a health disparities framework.

Method: 418 community-dwelling adults (50% nonHispanic Black, 50% nonHispanic White) aged 55+ from the Michigan Cognitive Aging Project retrospectively reported on nine ACEs. Baseline global cognition was a z-score composite of five factor scores from a comprehensive neuropsychological battery. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Cardiovascular health was operationalized through systolic blood pressure. A mediation model controlling for sociodemographics, childhood health, and childhood socioeconomic status estimated indirect effects of ACEs on global cognition via depressive symptoms and blood pressure. Racial differences were probed via t-tests and stratified models.

Results: A negative indirect effect of ACEs on cognition was observed through depressive symptoms [β = -.040, 95% CI (-.067, -.017)], but not blood pressure, for the whole sample. Black participants reported more ACEs (Cohen's d = .21), reported more depressive symptoms (Cohen's d = .35), higher blood pressure (Cohen's d = .41), and lower cognitive scores (Cohen's d = 1.35) compared to White participants. In stratified models, there was a negative indirect effect through depressive symptoms for Black participants [β = -.074, 95% CI (-.128, -.029)] but not for White participants.

Conclusions: These results highlight the need to consider racially patterned contextual factors across the life course. Such factors could exacerbate the negative impact of ACEs and related mental health consequences and contribute to racial disparities in cognitive aging.

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来源期刊
CiteScore
5.40
自引率
3.80%
发文量
185
审稿时长
4-8 weeks
期刊介绍: The Journal of the International Neuropsychological Society is the official journal of the International Neuropsychological Society, an organization of over 4,500 international members from a variety of disciplines. The Journal of the International Neuropsychological Society welcomes original, creative, high quality research papers covering all areas of neuropsychology. The focus of articles may be primarily experimental, applied, or clinical. Contributions will broadly reflect the interest of all areas of neuropsychology, including but not limited to: development of cognitive processes, brain-behavior relationships, adult and pediatric neuropsychology, neurobehavioral syndromes (such as aphasia or apraxia), and the interfaces of neuropsychology with related areas such as behavioral neurology, neuropsychiatry, genetics, and cognitive neuroscience. Papers that utilize behavioral, neuroimaging, and electrophysiological measures are appropriate. To assure maximum flexibility and to promote diverse mechanisms of scholarly communication, the following formats are available in addition to a Regular Research Article: Brief Communication is a shorter research article; Rapid Communication is intended for "fast breaking" new work that does not yet justify a full length article and is placed on a fast review track; Case Report is a theoretically important and unique case study; Critical Review and Short Review are thoughtful considerations of topics of importance to neuropsychology and include meta-analyses; Dialogue provides a forum for publishing two distinct positions on controversial issues in a point-counterpoint format; Special Issue and Special Section consist of several articles linked thematically; Letter to the Editor responds to recent articles published in the Journal of the International Neuropsychological Society; and Book Review, which is considered but is no longer solicited.
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