Association of Adverse Childhood Experiences and Social Isolation With Later-Life Cognitive Function Among Adults in China

Lin, Li; Cao, Bing; Chen, Weiqing; Li, Jinghua; Zhang, Yuying; Guo, Vivian Yawei

doi:10.1001/jamanetworkopen.2022.41714

Cited by 58 publications

(39 citation statements)

References 54 publications

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“…In our study, there was a bidirectional relationship between global cognition and gait speed and between specific domains (mental intactness and episodic memory) and gait speed. The mental status in the CHARLS describes time orientation, numerical ability, and visual and spatial abilities, and is similar to executive function [ 43 ]. Compared with these 2 studies, the sample size in our study was relatively larger.…”

Section: Discussionmentioning

confidence: 99%

The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study

Li¹,

Zhang²,

Zou³

et al. 2023

JMIR Public Health Surveill

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Background Cognitive and gait speed decline are common conditions in older adults and are often associated with future adverse consequences. Although an association between cognitive function and gait speed has been demonstrated, its temporal sequence remains unclear, especially in older Chinese adults. Clarifying this could help identify interventions to improve public health in older adults. Objective This study aims to examine the longitudinal reciprocal association between gait speed and cognitive function and the possible temporal sequence of changes in both factors in a national longitudinal cohort. Methods Data were derived from 2 waves (2011 baseline and 2015 follow-up) of the China Health and Retirement Longitudinal Study (CHARLS). Participants 60 years or older, without dementia or Parkinson disease at baseline, and with completed data on gait speed and cognition at both baseline and follow-up were included. Usual gait speed was measured over two 2.5-m walks. Mental intactness and episodic memory were used to assess global cognitive function. Cross-lagged panel models and linear mixed-effects models were used to examine the association between cognition and gait speed over time. Standardized coefficients were reported. Results A total of 3009 participants (mean age 66.4 years, SD 5.4 years; 1422/3009, 47.26%, female participants) were eligible for inclusion in our analyses. Cross-lagged panel analyses revealed that after accounting for baseline gait speed, cognition, and potential confounders, baseline global cognition (β=.117, 95% CI 0.082-0.152; P<.001), mental intactness (β=.082, 95% CI 0.047-0.118; P<.001), and episodic memory (β=.102, 95% CI 0.067-0.137; P<.001) were associated with subsequent gait speed. Simultaneously, baseline gait speed was also associated with subsequent global cognition (β=.056, 95% CI 0.024-0.087; P=.001), mental intactness (β=.039, 95% CI 0.008-0.069; P=.01), and episodic memory (β=.057, 95% CI 0.023-0.092; P=.001). The comparison of standardized cross-lagged coefficients suggested that the effect size of baseline global cognition on subsequent gait speed was significantly larger than the reverse effect (χ12=6.50, P for difference=.01). However, the effects of both mental intactness and episodic memory on subsequent gait speed were not significantly stronger than those of the reverse pathway (χ12=3.33, P for difference=.07 and χ12=3.21, P for difference=.07). Linear mixed-effects analyses further supported these bidirectional relationships, revealing that lower baseline cognitive scores predicted steeper declines in gait speed trajectory, and slower baseline gait speed predicted more declines in cognitive trajectory over time. Conclusions There is a longitudinal bidirectional association between usual gait speed and both global cognitive function and specific domains of mental intactness and episodic memory among Chinese older adults. Baseline global cognition is likely to have a stronger association with subsequent gait speed than the reverse pathway. This interlinkage is noteworthy and may have implications for public health. Maintaining normal cognitive function may be an important interventional strategy for mitigating age-related gait speed reduction.

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Section: Discussionmentioning

confidence: 99%

The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study

Li¹,

Zhang²,

Zou³

et al. 2023

JMIR Public Health Surveill

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“…Second, we assessed the moderating role of living alone in the association between pet ownership and cognitive function by including pet ownership, living alone, time, pet ownership × time, living alone × time, pet ownership × living alone, pet ownership × living alone × time, and the covariates in model 2. Stratified analyses of living alone were further conducted if the 3-way interaction (ie, pet ownership × living alone × time) was statistically significant …”

Section: Methodsmentioning

confidence: 99%

Pet Ownership, Living Alone, and Cognitive Decline Among Adults 50 Years and Older

Li,

Wang,

Zhu

et al. 2023

JAMA Netw Open

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ImportanceIt remains unclear whether pet ownership is associated with cognitive decline and to what extent pet ownership mitigates the association between living alone and cognitive decline.ObjectiveTo explore the association of pet ownership with cognitive decline, the interaction between pet ownership and living alone, and the extent to which pet ownership mitigates the association between living alone and cognitive decline in older adults.Design, Setting, and ParticipantsThis cohort study used data from waves 5 (June 2010 to July 2011) to 9 (from June 2018 to July 2019) in the English Longitudinal Study of Ageing. Participants included adults 50 years and older. Data were analyzed from April 1 to June 30, 2023.ExposuresPet ownership and living alone in wave 5.Main Outcomes and MeasuresIn waves 5 to 9, verbal memory and verbal fluency were assessed, and composite verbal cognition was further calculated.ResultsOf the 7945 participants included, the mean (SD) age was 66.3 (8.8) years, and 4446 (56.0%) were women. Pet ownership was associated with slower rates of decline in composite verbal cognition (β = 0.008 [95% CI, 0.002-0.014] SD/y), verbal memory (β = 0.006 [95% CI, 0.001-0.012] SD/y), and verbal fluency (β = 0.007 [95% CI, 0.001-0.013] SD/y). Three-way interaction tests showed that living alone was a significant modifier in all 3 associations. Stratified analyses showed that pet ownership was associated with slower rates of decline in composite verbal cognition (β = 0.023 [95% CI, 0.011-0.035] SD/y), verbal memory (β = 0.021 [95% CI, 0.008-0.034] SD/y), and verbal fluency (β = 0.018 [95% CI, 0.005-0.030] SD/y) among individuals living alone, but not among those living with others. Joint association analyses showed no significant difference in rates of decline in composite verbal cognition, verbal memory, or verbal fluency between pet owners living alone and pet owners living with others.Conclusions and RelevanceIn this cohort study, pet ownership was associated with slower rates of decline in verbal memory and verbal fluency among older adults living alone, but not among those living with others, and pet ownership offset the associations between living alone and declining rates in verbal memory and verbal fluency. Further studies are needed to assess whether pet ownership slows the rate of cognitive decline in older adults living alone.

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“…Cognitive Function. Cognitive function was measured into two dimensions: episodic memory and executive function (Lin et al, 2022;Yao et al, 2022). Episodic memory was divided into immediate word recall (score range: 0-10 points) and delayed word recall (score range: 0-10 points).…”

Section: Methodsmentioning

confidence: 99%

“…First, studies on this theme have usually combined emotional neglect with child maltreatment or adverse childhood experiences using a cumulative risk model (Ding & He, 2021; Lin et al, 2022). Research that treats emotional neglect as an independent variable is scarce.…”

mentioning

confidence: 99%

Childhood Emotional Neglect and Cognitive Function Among Middle-Aged and Older Adults: Mediating Role of Social Engagement

Wang,

Xia,

Zhang

2023

J Interpers Violence

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Studies have demonstrated that childhood maltreatment and adverse experiences lead to impaired cognitive function. However, relatively few studies have examined the independent effect of childhood emotional neglect on cognitive function in middle-aged and older adults, and the role of social engagement in this relationship. Using a sample from the China Health and Retirement Longitudinal Study, the current study examined the mediating role of social engagement in the association between childhood emotional neglect and cognitive function among middle-aged and older adults. Participants were 32,540 middle-aged and older adults ( Mage = 63.45, SD = 8.83). Data were analyzed using a fixed effects model for panel data and bootstrap resampling method. Results showed that participants who experienced emotional neglect had poorer cognitive function (β = −.068, p < .001). Social engagement mediated 7.55% of the association between emotional neglect and cognitive function (β = −.004, 95% CI [−0.006, −0.002], p < .05). The results indicated that interventions are required to improve awareness of emotional neglect and facilitate healthy parenting practices. Further research on how to motivate adults who experienced emotional neglect to engage in social activities is necessary.

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Association of Adverse Childhood Experiences and Social Isolation With Later-Life Cognitive Function Among Adults in China

Cited by 58 publications

References 54 publications

The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study

The Bidirectional Association Between Cognitive Function and Gait Speed in Chinese Older Adults: Longitudinal Observational Study

Pet Ownership, Living Alone, and Cognitive Decline Among Adults 50 Years and Older

Childhood Emotional Neglect and Cognitive Function Among Middle-Aged and Older Adults: Mediating Role of Social Engagement

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