Association of adverse childhood experiences and late‐life cognition in Black Americans from the Study of Healthy Aging in African Americans (STAR)

Abstract

AbstractBackgroundThough Black Americans are more likely to experience adverse childhood experiences (ACEs) not much is known how these experiences are associated with late‐life cognitive outcomes in Black Americans. We examined the association between ACEs and late life cognition in the Study of Healthy Aging in African Americans (STAR).MethodsLaunched in 2018, STAR is a cohort study of cognitive aging and brain health in 764 Black Americans ages ≥50 years. ACEs were self‐reported via a nine‐item questionnaire. Executive function, semantic memory, and verbal episodic memory were measured using the Spanish and English Neuropsychological Assessment Scales (SENAS) and scores were z‐standardized. Linear regression models were used to associate ACEs exposure with cognitive domains adjusting for age, gender, participant education, and parental education (proxy for childhood socioeconomic status).ResultsThe majority of participants were female (69%) and the mean age was 69 years (SD=8.7) Table 1. Most of the respondents (73%) reported having one or more ACEs with parental separation (39%), serious family illness (36%), and witnessing domestic violence (31%) being most common. Other ACEs included parent remarried (26%), substance abuse by a family member (25%), parental job loss (15%), parental incarceration (8%), maternal death (6.5%), and paternal death (10.4%). Most ACEs were not significantly associated with domain specific cognitive scores, except experiencing the death of a father, which was associated with lower semantic memory (β=‐0.36; 95% CI: ‐0.56, ‐0.15; Table 2). Gender‐stratified models showed that the association between death of a father and lower semantic memory was significant for female (β=‐0.45; 95% CI: ‐0.69, ‐0.21) but not males (β=‐0.17; 95% CI: ‐0.54, 0.20). There was no evidence that the relationship between other ACEs and domain‐specific cognitive scores varied by gender.ConclusionsACEs were common among Black Americans in this cohort, but only death of a father in early life was associated with lower late life semantic memory, especially among women. Mechanisms of this association are unclear. Future studies with longitudinal data are needed to understand whether ACEs are related to cognitive decline over time in this population.