Time-lagged associations between two adverse childhood experiences and later-life cognitive function through educational attainment and stroke

Abstract

Objective: Adverse childhood experiences (ACEs) have been associated with worse cognitive health in older adulthood. This study aimed to extend findings on the specificity, persistence, and pathways of associations between two ACEs and cognition by using a comprehensive neuropsychological battery and a time-lagged mediation design. Method: Participants were 3304 older adults in the Health and Retirement Study Harmonized Cognitive Assessment Protocol. Participants retrospectively reported whether they were exposed to parental substance abuse or experienced parental physical abuse before age 18. Factor scores derived from a battery of 13 neuropsychological tests indexed cognitive domains of episodic memory, executive functioning, processing speed, language, and visuospatial function. Structural equation models examined self-reported years of education and stroke as mediators, controlling for sociodemographics and childhood socioeconomic status. Results: Parental substance abuse in childhood was associated with worse later-life cognitive function across all domains, in part via pathways involving educational attainment and stroke. Parental physical abuse was associated with worse cognitive outcomes via stroke independent of education. Conclusions: This national longitudinal study in the United States provides evidence for broad and persistent indirect associations between two ACEs and cognitive aging via differential pathways involving educational attainment and stroke. Future research should examine additional ACEs and mechanisms as well as moderators of these associations to better understand points of intervention.

Adverse childhood experiences and cognitive function in later life: the sequential mediating roles of education level and adult loneliness

“…Moreover, recent research has identified specific adverse experiences that may further exacerbate cognitive declines by influencing educational attainment. For instance, one study demonstrated a robust and enduring indirect association between parental substance abuse and poorer cognitive function in later life, mediated through educational level ( 16 ). Similarly, Halpin et al observed that heightened childhood adversity could amplify susceptibility to cognitive impairment by shaping the early educational experiences of older adults ( 17 ).…”