Childhood and adulthood traumatic events differentially associate with cognitive aging among Black and White elders in the Health and Retirement Study

Abstract

AbstractBackgroundModifiable sociocontextual factors powerfully shape ADRD risk, and demonstrably contribute to well‐established racial disparities in cognitive aging. Stressful experiences occurring across the lifespan associate with brain aging and poor cognitive outcomes. However, the importance of timing and even type of stressor remains understudied. We examined relationships between childhood and adulthood traumatic events and cognition among non‐Hispanic Black and White older adults in the Health and Retirement Study (HRS).MethodThe sample included non‐demented adults (N=5,725) aged 65+ with lifetime stress data and complete cognitive testing at the 2006/08, 2010/12, and/or 2014/16 waves. Trauma measures included childhood (0‐11), and adulthood (0‐7) traumatic event counts. Outcomes included global cognition, immediate recall, and delayed recall (Telephone Interview for Cognitive Status). Each exposure‐outcome pair was investigated in separate linear mixed effect models including baseline trauma count, a quadratic trauma term to test for non‐linear relationships, and subject‐specific random intercept. Omnibus Likelihood Ratio Tests (LRT) were conducted to determine if number of traumatic events associated overall with each cognitive outcome. The sample was stratified by race before analysis.ResultBlack participants (N=651) were younger and reported less formal education than White participants (N=5,074). Number of traumatic events in adulthood did not vary by race, but Black participants reported slightly fewer childhood traumas (Table 1) than Whites. Among Whites, childhood traumas associated with poorer global cognition scores but traumas in adulthood showed very modest positive associations across cognitive domains. Among Black participants, no association between childhood trauma and later‐life cognition was observed. A significant non‐linear term for traumatic events indicated cross‐domain cognitive detriment associated with high exposure to adulthood trauma (Table 2; Figure 1).ConclusionAverage exposure to traumas (eg., physical abuse, life‐threatening illness) was low, and in both Black and White older adults, some limited exposure to traumatic events during adulthood predicted modest cognitive benefit. Black HRS participants reporting many traumatic events during adulthood, but not childhood, showed dysfunction in global cognition and recall. Findings highlight importance of adverse events across the full life course, potential threshold effects and co‐occuring chronic stress conditions, and a need to identify resources that buffer impacts of trauma on biology and personal environment.