The impact of adverse childhood experiences on cognitive function among middle-aged and older Chinese adults: Multiple mediators of cognitive reserve and depressive symptoms

Background

Adverse childhood experiences (ACEs) are associated with later cognitive decline. However, the mechanisms underlying the effects of different types of ACEs are unclear. This study examined how ACEs impact cognitive function, specifically deprivation-related ACEs (DrACEs) and threat-related ACEs (TrACEs). Additionally, we explored the potential role of cognitive reserve (CR) and depression in these relationships.

Methods

Data were taken from the China Health and Retirement Longitudinal Study (CHARLS) of 2014 and 2020. CR, depressive symptoms and cognitive function measures were collected from 2020. ACEs were assessed at the 2014 Life Course Survey. The main analyses included 7113 participants aged 45 years or older. To explore potential associations, linear regression and SPSS Macro PROCESS were employed.

Results

Among middle-aged and older adults, only exposure to DrACEs was associated with cognitive function ((β = −0.101 [95%CI: −0.150, −0.052]) for DrACEs = 1; (β = −0.250 [95%CI: −0.333, −0.167]) for DrACEs ≥ 2). The indirect effects mediated by CR and depressive symptoms were statistically significant.

Limitations

The use of retrospective self-reported data for ACEs may introduce recall bias.

Conclusions

Chinese middle-aged and older adults who have experienced DrACEs exhibit poorer cognitive function, while the association between TrACEs and cognitive function was not significant. And the impact of DrACEs on cognitive function was mediated by CR and depressive symptoms. Further research is necessary to validate our findings, establish causal links, and uncover the underlying mechanisms involved.