Early life factors and dementia risk: A study of adverse childhood experiences and later-life cognition and behaviour

IntroductionAdverse childhood experiences (ACEs) are associated with brain alterations and cognitive decline. In later life, cognitive impairment and mild behavioural impairment (MBI) are associated with greater dementia risk. Objective & Study DesignWe investigated whether more severe ACEs are cross-sectionally associated with worse later-life cognitive and behavioural symptoms. MethodData are from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging (CAN-PROTECT). Measures included the Childhood Trauma Screener (CTS-5), neuropsychological testing, Everyday Cognition (ECog)-II scale, and MBI Checklist (MBI-C). Linear regressions modelled associations between ACEs severity and neuropsychological test scores. Multivariable negative binomial regressions (zero-inflated, if appropriate) modelled associations between ACEs severity and ECog-II and MBI-C scores. All models controlled for age, sex, education, and ethnocultural origin. Clinical diagnoses of depression and/or anxiety were explored as covariates or mediators. ResultsIn adjusted analyses, higher ACEs scores were associated with worse performance on Trail-Making B (standardized b=0.10, q=0.003), Switching Stroop (b=-0.08, q=0.027), Paired Associates Learning (b=-0.08, q=0.049), and Digit Span (b=-0.08, q=0.029). Higher ACEs scores were also associated with higher ECog-II (b=1.08, q=0.029) and MBI-C (b=1.20, q<0.001) scores; these associations were neither mediated by affective symptoms (ECog p=0.16; MBI p=0.13) nor moderated by sex (ECog p=0.09; MBI p=0.46). ConclusionOlder adults with a history of more severe ACEs show greater cognitive and behavioural risk markers for dementia that cannot be explained by previous psychiatric history. Further research into ACEs as an early modifiable risk factor for dementia is warranted.