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Impact of Childhood Adversity on Late-Life Cognition in Older Puerto Rican Adults

Language English Country United States Media print

Document type Journal Article

Grant support
R01 AG064769 NIA NIH HHS - United States
FL190100011 ARC Laureate Fellowship
CE170100005 Australian Research Council Centre of Excellence in Population Ageing Research

OBJECTIVES: This study examined the association between childhood adversity and late-life cognitive outcomes among older Puerto Rican adults. METHODS: Data were from the Puerto Rican Elder: Health Conditions study, a population-based cohort of 3,713 older Puerto Rican adults (mean age 72.5 years; 60% female). Adverse childhood experiences were categorized into four factors: economic hardship, parental illiteracy, childhood illness, and neighborhood disadvantage. Cognition was assessed with the Mini-Mental Cabán (MMC). For our analyses, cognitive impairment was defined as scoring 1.5 standard deviations below the expected score, adjusted for age, sex, education, and reading ability. Ordinal logistic regression (baseline) and generalized linear mixed models (all 3 waves) analyzed MMC scores; generalized estimating equations assessed incident cognitive impairment (Waves 2 and 3). RESULTS: All four adversity factors were associated with poorer MMC scores at baseline. Parental illiteracy (β = -0.35, p < .001) and neighborhood disadvantage (β = -0.27, p < .001) showed stronger associations than economic hardship (β = -0.10, p = .003) and childhood illness (β = -0.21, p < .001). No factors were significantly related to changes in cognitive scores over time. Depressive symptoms and self-rated health partially mediated cross-sectional relationships, with depressive symptoms showing a stronger effect. All adversity factors except economic hardship were linked to baseline cognitive impairment (OR = 1.42 parent illiteracy, OR = 1.24 childhood illness, OR = 1.82 neighborhood disadvantage, p < .05). Only neighborhood disadvantage was associated with incident cognitive impairment (OR = 1.19, p = .003). DISCUSSION: This study highlights the lasting effect of childhood adversity on late-life cognitive health among older Puerto Ricans, suggesting that addressing early adversity may promote cognitive health later in life.

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Baranyi, G., Conte, F., Deary, I. J., Shortt, N., Thompson, C. W., Cox, S. R., & Pearce, J. (2023). Neighbourhood deprivation across eight decades and late-life cognitive function in the Lothian Birth Cohort 1936: A life-course study. Age and Ageing, 52(4), afad056. https://doi.org/10.1093/ageing/afad056 PubMed DOI PMC

Barnes, L. L., Wilson, R. S., Everson-Rose, S. A., Hayward, M. D., Evans, D. A., & Mendes de Leon, C. F. (2012). Effects of early-life adversity on cognitive decline in older African Americans and whites. Neurology, 79(24), 2321–2327. https://doi.org/10.1212/WNL.0b013e318278b607 PubMed DOI PMC

Bodryzlova, Y., Kim, A., Michaud, X., Andre, C., Belanger, E., & Moullec, G. (2023). Social class and the risk of dementia: A systematic review and meta-analysis of the prospective longitudinal studies. Scandinavian Journal of Public Health, 51(8), 1122–1135. https://doi.org/10.1177/14034948221110019 PubMed DOI PMC

Camacho-Mercado, C. L., Figueroa, R., Acosta, H., Arnold, S. E., & Vega, I. E. (2016). Profiling of Alzheimer’s disease patients in Puerto Rico: A comparison of two distinct socioeconomic areas. SAGE Open Medicine, 4, 2050312115627826. https://doi.org/10.1177/2050312115627826 PubMed DOI PMC

Cangur, S., & Ercan, I. (2015). Comparison of model fit indices used in structural equation modeling under multivariate normality. Journal of Modern Applied Statistical Methods, 14(1), 152–167. https://doi.org/10.22237/jmasm/1430453580. https://jmasm.com/index.php/jmasm/article/view/759/760 DOI

Cano, T., Perales, F., & Baxter, J. (2019). A matter of time: Father involvement and child cognitive outcomes. Journal of Marriage and Family, 81(1), 164–184. https://doi.org/10.1111/jomf.12532 DOI

Corney, K. B., West, E. C., Quirk, S. E., Pasco, J. A., Stuart, A. L., Manavi, B. A., Kavanagh, B. E., & Williams, L. J. (2022). The relationship between adverse childhood experiences and Alzheimer’s disease: A systematic review. Frontiers in Aging Neuroscience, 14, 831378. https://doi.org/10.3389/fnagi.2022.831378 PubMed DOI PMC

Costello, A. B., & Osborne, J. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research, and Evaluation, 10(1), 7. https://doi.org/10.7275/jyj1-4868 DOI

Dauncey, M. J., & Bicknell, R. J. (1999). Nutrition and neurodevelopment: Mechanisms of developmental dysfunction and disease in later life. Nutrition Research Reviews, 12(2), 231–253. https://doi.org/10.1079/095442299108728947 PubMed DOI

Davis, M. C., Lemery-Chalfant, K., Yeung, E. W., Luecken, L. J., Zautra, A. J., & Irwin, M. R. (2019). Interleukin-6 and depressive mood symptoms: Mediators of the association between childhood abuse and cognitive performance in middle-aged adults. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 53(1), 29–38. https://doi.org/10.1093/abm/kay014 PubMed DOI PMC

Donley, G. A. R., Lonnroos, E., Tuomainen, T. P., & Kauhanen, J. (2018). Association of childhood stress with late-life dementia and Alzheimer’s disease: The KIHD study. European Journal of Public Health, 28(6), 1069–1073. https://doi.org/10.1093/eurpub/cky134 PubMed DOI

Ene, M., Leighton, E. A., Blue, G. L., & Bell, B. A. (2015). Multilevel models for categorical data using SAS® PROC GLIMMIX: The basics. SAS Global Forum. https://support.sas.com/resources/papers/proceedings15/3430-2015.pdf

Gao, X., Scott, T., Falcon, L. M., Wilde, P. E., & Tucker, K. L. (2009). Food insecurity and cognitive function in Puerto Rican adults. American Journal of Clinical Nutrition, 89(4), 1197–1203. https://doi.org/10.3945/ajcn.2008.26941 PubMed DOI PMC

Gold, A. L., Meza, E., Ackley, S. F., Mungas, D. M., Whitmer, R. A., Mayeda, E. R., Miles, S., Eng, C. W., Gilsanz, P., & Glymour, M. M. (2021). Are adverse childhood experiences associated with late-life cognitive performance across racial/ethnic groups: Results from the kaiser healthy aging and diverse life experiences study baseline. BMJ Open, 11(2), e042125. https://doi.org/10.1136/bmjopen-2020-042125 PubMed DOI PMC

Gonzalez, H. M., Tarraf, W., Schneiderman, N., Fornage, M., Vasquez, P. M., Zeng, D., Youngblood, M., Gallo, L. C., Daviglus, M. L., Lipton, R. B., Kaplan, R., Ramos, A. R., Lamar, M., Thomas, S., Chai, A., & DeCarli, C. (2019). Prevalence and correlates of mild cognitive impairment among diverse Hispanics/Latinos: Study of latinos-investigation of neurocognitive aging results. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 15(12), 1507–1515. https://doi.org/10.1016/j.jalz.2019.08.202 PubMed DOI PMC

Guryan, J., Hurst, E., & Kearney, M. (2008). Parental education and parental time with children. Journal of Economic Perspectives, 22(3), 23–46. https://doi.org/10.1257/jep.22.3.23 DOI

Halahakoon, D. C., Lewis, G., & Roiser, J. P. (2019). Cognitive impairment and depression-cause, consequence, or coincidence? JAMA Psychiatry, 76(3), 239–240. https://doi.org/10.1001/jamapsychiatry.2018.3631 PubMed DOI

Kessler, R. C., McLaughlin, K. A., Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., Aguilar-Gaxiola, S., Alhamzawi, A. O., Alonso, J., Angermeyer, M., Benjet, C., Bromet, E., Chatterji, S., de Girolamo, G., Demyttenaere, K., Fayyad, J., Florescu, S., Gal, G., Gureje, O., … Williams, D. R. (2010). Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. The British Journal of Psychiatry: The Journal of Mental Science, 197(5), 378–385. https://doi.org/10.1192/bjp.bp.110.080499 PubMed DOI PMC

Kobayashi, L. C., Farrell, M. T., Payne, C. F., Mall, S., Montana, L., Wagner, R. G., Kahn, K., Tollman, S., & Berkman, L. F. (2020). Adverse childhood experiences and domain-specific cognitive function in a population-based study of older adults in rural South Africa. Psychology and Aging, 35(6), 818–830. https://doi.org/10.1037/pag0000552 PubMed DOI PMC

Korhonen, K., Leinonen, T., Tarkiainen, L., Einio, E., & Martikainen, P. (2023). Childhood socio-economic circumstances and dementia: Prospective register-based cohort study of adulthood socio-economic and cardiovascular health mediators. International Journal of Epidemiology, 52(2), 523–535. https://doi.org/10.1093/ije/dyac205 PubMed DOI PMC

Korner, A., Lauritzen, L., Abelskov, K., Gulmann, N., Marie Brodersen, A., Wedervang-Jensen, T., & Marie Kjeldgaard, K. (2006). The geriatric depression scale and the cornell scale for depression in dementia. A validity study. Nordic Journal of Psychiatry, 60(5), 360–364. https://doi.org/10.1080/08039480600937066 PubMed DOI

Kunzi, M., Gheorghe, D. A., Kliegel, M., Ballhausen, N., Gallacher, J., & Bauermeister, S. (2022). Cumulative life course adversity, mental health, and cognition in the UK biobank. Scientific Reports, 12(1), 14700. https://doi.org/10.1038/s41598-022-18928-9 PubMed DOI PMC

Lapp, M. (1995). The rise and fall of Puerto Rico as a social laboratory, 1945–1965. Social Science History, 19(2), 169–199. https://doi.org/10.2307/1171509 DOI

Lian, J., Kiely, K. M., & Anstey, K. J. (2022). Cumulative risk, factor analysis, and latent class analysis of childhood adversity data in a nationally representative sample. Child Abuse and Neglect, 125, 105486. https://doi.org/10.1016/j.chiabu.2022.105486 PubMed DOI

Lian, J., Kiely, K. M., Callaghan, B. L., & Anstey, K. J. (2024). Childhood adversity is associated with anxiety and depression in older adults: A cumulative risk and latent class analysis. Journal of Affective Disorders, 354, 181–190. https://doi.org/10.1016/j.jad.2024.03.016 PubMed DOI

Lian, J., Kiely, K. M., Callaghan, B. L., Eramudugolla, R., Mortby, M., & Anstey, K. J. (2024). No association found: Adverse childhood experiences and cognitive impairment in older Australian adults. The Journal of Prevention of Alzheimer's Disease, 11(6), 1818–1825. https://doi.org/10.14283/jpad.2024.133 PubMed DOI PMC

Lovden, M., Fratiglioni, L., Glymour, M. M., Lindenberger, U., & Tucker-Drob, E. M. (2020). Education and cognitive functioning across the life span. Psychological Science in the Public Interest: A Journal of the American Psychological Society, 21(1), 6–41. https://doi.org/10.1177/1529100620920576 PubMed DOI PMC

Lowry, E., McInerney, A., Schmitz, N., & Deschenes, S. S. (2022). Adverse childhood experiences and cognitive function in adulthood: Examining the roles of depressive symptoms and inflammation in a prospective cohort study. Social Psychiatry and Psychiatric Epidemiology, 57(12), 2367–2377. https://doi.org/10.1007/s00127-022-02315-w PubMed DOI PMC

McCrory, E., De Brito, S. A., & Viding, E. (2010). Research review: The neurobiology and genetics of maltreatment and adversity. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 51(10), 1079–1095. https://doi.org/10.1111/j.1469-7610.2010.02271.x PubMed DOI

McEniry, M. (2013). Early-life conditions and older adult health in low- and middle-income countries: A review. Journal of Developmental Origins of Health and Disease, 4(1), 10–29. https://doi.org/10.1017/S2040174412000499 PubMed DOI PMC

McEwen, B. S. (1998). Stress, adaptation, and disease. Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840(1), 33–44. https://doi.org/10.1111/j.1749-6632.1998.tb09546.x PubMed DOI

McKay, M. T., Kilmartin, L., Meagher, A., Cannon, M., Healy, C., & Clarke, M. C. (2022). A revised and extended systematic review and meta-analysis of the relationship between childhood adversity and adult psychiatric disorder. Journal of Psychiatric Research, 156, 268–283. https://doi.org/10.1016/j.jpsychires.2022.10.015 PubMed DOI

Migeot, J., Calivar, M., Granchetti, H., Ibanez, A., & Fittipaldi, S. (2022). Socioeconomic status impacts cognitive and socioemotional processes in healthy ageing. Scientific Reports, 12(1), 6048. https://doi.org/10.1038/s41598-022-09580-4 PubMed DOI PMC

Monnat, S. M., & Chandler, R. F. (2015). Long term physical health consequences of adverse childhood experiences. The Sociological Quarterly, 56(4), 723–752. https://doi.org/10.1111/tsq.12107 PubMed DOI PMC

Nilaweera, D., Freak-Poli, R., Gurvich, C., Ritchie, K., Chaudieu, I., Ancelin, M. L., & Ryan, J. (2022). The association between adverse childhood events and later-life cognitive function and dementia risk. Journal of Affective Disorders, 304, 128–132. https://doi.org/10.1016/j.jad.2022.02.062 PubMed DOI

Oropesa, R. S., & Landale, N. S. (2000). From austerity to prosperity? Migration and child poverty among mainland and island Puerto Ricans. Demography, 37(3), 323–338. https://www.ncbi.nlm.nih.gov/pubmed/10953807 PubMed

Palloni, A., McEniry, M., Dávila, A. L., Gurucharri, A. G. (2010). The influence of early conditions on health status among elderly Puerto Ricans. Social Biology, 52(3-4), 132–163. doi: https://doi.org/10.1080/19485565.2005.9989106 PubMed DOI

Palloni, A., & Souza, L. (2013). The fragility of the future and the tug of the past: Longevity in Latin America and the Caribbean. Demographic Research, 29, 543–578. https://doi.org/10.4054/DemRes.2013.29.21 PubMed DOI PMC

Patel, P., & Oremus, M. (2023). The association between adverse childhood experiences and late-life cognition: A systematic review of cross-sectional and case-control studies. The Gerontologist, 63(6), 1087–1103. https://doi.org/10.1093/geront/gnac041 PubMed DOI

Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. https://doi.org/10.3758/brm.40.3.879 PubMed DOI

Raymond, C., Marin, M. F., Majeur, D., & Lupien, S. (2018). Early child adversity and psychopathology in adulthood: HPA axis and cognitive dysregulations as potential mechanisms. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 85, 152–160. https://doi.org/10.1016/j.pnpbp.2017.07.015 PubMed DOI

Reynolds, A., & Greenfield, E. A. (2024). Diminished returns of higher parental education on cognition for black adults in middle and later life. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 79(3), gbad181. https://doi.org/10.1093/geronb/gbad181 PubMed DOI PMC

Rogers, M. A., Plassman, B. L., Kabeto, M., Fisher, G. G., McArdle, J. J., Llewellyn, D. J., Potter, G. G., & Langa, K. M. (2009). Parental education and late-life dementia in the United States. Journal of Geriatric Psychiatry and Neurology, 22(1), 71–80. https://doi.org/10.1177/0891988708328220 PubMed DOI PMC

Rönnlund, M., & Nilsson, L.-G. (2008). The magnitude, generality, and determinants of Flynn effects on forms of declarative memory and visuospatial ability: Time-sequential analyses of data from a Swedish cohort study. Intelligence, 36(3), 192–209. https://doi.org/10.1016/j.intell.2007.05.002 DOI

Rotstein, A., & Levine, S. Z. (2021). Childhood infectious diseases and old age cognitive functioning: A nationally representative sample of community-dwelling older adults. International Psychogeriatrics, 33(1), 75–82. https://doi.org/10.1017/S1041610220001404 PubMed DOI PMC

Sampson, R. J., Morenoff, J. D., & Gannon-Rowley, T. (2002). Assessing “Neighborhood Effects”: Social processes and new directions in research. Annual Review of Sociology, 28(1), 443–478. https://doi.org/10.1146/annurev.soc.28.110601.141114 DOI

Sanchez-Ayendez, M., Caban, C. A., Fernandez, L., Rosich, W., Davila, A. L., Larriuz, M. C., Hernandez, J., Garcia Guruxarri, A., & Palloni, A. (2003). A short psychometric scale to\] evaluate the cognitive status of aged Spanish speakers. Puerto Rico Health Sciences Journal, 22(4), 377–383. https://www.ncbi.nlm.nih.gov/pubmed/14768504(Una escala psicometrica breve para evaluar el estado cognitivo de hispanoparlantes de edad mayor.) PubMed

Scazufca, M., Menezes, P. R., Araya, R., Di Rienzo, V. D., Almeida, O. P., Gunnell, D., & Lawlor, D. A.; Sao Paulo Ageing & Health Study (2008). Risk factors across the life course and dementia in a Brazilian population: Results from the Sao Paulo Ageing & Health Study (SPAH). International Journal of Epidemiology, 37(4), 879–890. https://doi.org/10.1093/ije/dyn125. https://pubmed.ncbi.nlm.nih.gov/18583392/ PubMed DOI

Schickedanz, H. B., Jennings, L. A., & Schickedanz, A. (2022). The association between adverse childhood experiences and positive dementia screen in American Older Adults. Journal of General Internal Medicine, 37(10), 2398–2404. https://doi.org/10.1007/s11606-021-07192-8 PubMed DOI PMC

Segretin, M. S., Hermida, M. J., Prats, L. M., Fracchia, C. S., Ruetti, E., & Lipina, S. J. (2016). Childhood poverty and cognitive development in Latin America in the 21st Century. New Directions for Child and Adolescent Development, 2016(152), 9–29. https://doi.org/10.1002/cad.20162 PubMed DOI

Sharkey, P., & Elwert, F. (2011). The legacy of disadvantage: Multigenerational neighborhood effects on cognitive ability. American Journal of Sociology, 116(6), 1934–1981. https://doi.org/10.1086/660009 PubMed DOI PMC

Tani, Y., Fujiwara, T., & Kondo, K. (2020). Association between adverse childhood experiences and dementia in older Japanese Adults. JAMA Network Open, 3(2), e1920740. https://doi.org/10.1001/jamanetworkopen.2019.20740 PubMed DOI

United States Puerto Rico Reconstruction Administration (1938). Censo de Puerto Rico: 1935. Población y agricultura. Washington: United States Government Printing Office.

Wang, G., Zhou, Y., Duan, J., Kan, Q., Cheng, Z., & Tang, S. (2023). Effects of adverse childhood health experiences on cognitive function in Chinese middle-aged and older adults: Mediating role of depression. BMC Public Health, 23(1), 1293. https://doi.org/10.1186/s12889-023-16169-7 PubMed DOI PMC

Wang, X. J., Xu, W., Li, J. Q., Cao, X. P., Tan, L., & Yu, J. T. (2019). Early-Life risk factors for dementia and cognitive impairment in later life: A systematic review and meta-analysis. Journal of Alzheimer's Disease, 67(1), 221–229. https://doi.org/10.3233/JAD-180856 PubMed DOI

Wong, C. G., Miller, J. B., Zhang, F., Rissman, R. A., Raman, R., Hall, J. R., Petersen, M., Yaffe, K., Kind, A. J., O’Bryant, S. E., & Team, H.-H. S. (2023). Evaluation of neighborhood-level disadvantage and cognition in Mexican American and Non-Hispanic White adults 50 years and older in the US. JAMA Networks Open, 6(8), e2325325. https://doi.org/10.1001/jamanetworkopen.2023.25325 PubMed DOI PMC

Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49. https://doi.org/10.1016/0022-3956(82)90033-4 PubMed DOI

Yu, J., Patel, R. A., & Gilman, S. E. (2021). Childhood disadvantage, neurocognitive development and neuropsychiatric disorders: Evidence of mechanisms. Current Opinion in Psychiatry, 34(3), 306–323. https://doi.org/10.1097/YCO.0000000000000701 PubMed DOI PMC

Zeki Al Hazzouri, A., Haan, M. N., Galea, S., & Aiello, A. E. (2011). Life-course exposure to early socioeconomic environment, education in relation to late-life cognitive function among older Mexicans and Mexican Americans. Journal of Aging and Health, 23(7), 1027–1049. https://doi.org/10.1177/0898264311421524 PubMed DOI PMC

Zhang, Z., Liu, J., Li, L., & Xu, H. (2018). The long arm of childhood in china: Early-life conditions and cognitive function among middle-aged and older adults. Journal of Aging and Health, 30(8), 1319–1344. https://doi.org/10.1177/0898264317715975 PubMed DOI

Zmerli, S., & Castillo, J. C. (2015). Income inequality, distributive fairness and political trust in Latin America. Social Science Research, 52, 179–192. https://doi.org/10.1016/j.ssresearch.2015.02.003 PubMed DOI

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