Association of cognitive impairment with adverse childhood experiences: 2019 Results from 21 states

Our objective was to assess associations between 8 adverse childhood experiences (ACEs; physical, emotional, and sexual abuse as a child, or living in household with substance abuse, mental health problems, divorce, intimate partner violence, or incarceration) and subjective cognitive impairment (SCI: the disability question from the 2019 Behavioral Risk Factor Surveillance Surveys) and compare with cardiovascular disease (CVD) results. MethodsAdults (N=149,801) from 21 states with data on ACEs were studied using Stata in unadjusted and adjusted analysis controlled for demographics, selected health measures, CVD, and 6 CVD risk factors (smoking, overweight, hypertension, high cholesterol, diabetes, and inadequate physical activity). ResultsMean number of ACEs ranged from 0.8 among adults age 75+ to 2.2 for adults 18-34 years and 3.0 for adults with SCI. Prevalence rates were 12.6% for SCI, increasing with both number of ACES and CVD risk factors and 9.4% for CVD, only increasing with more CVD risk factors. Among age groups, SCI was highest for adults 18-24 years (17.2%) and lowest for those 65-74 years 9.4%) while CVD was highest among adults age 75+ (26.5%) and lowest for those 18-24 years (1.1%). Most results were confirmed by logistic regression with adjusted odds ratios (AOR) for SCI for each added ACE = 1.20 (95% CI 1.17-1.23) and each added CVD risk factor =1.10 (1.06-1.14) and for CVD AOR= 1.06 (1.03-1.08) for each added ACE and 1.42 (1.38-1.46) for each added risk factor. ConclusionResults suggest that ACEs may be a factor contributing to higher rates of SCI among younger vs. older adults.