Gender differences in the mediational pathway between trauma, depression and subjective cognitive decline

Abstract

AbstractBackgroundAdverse childhood experiences (ACEs) have been linked to subjective cognitive decline (SCD) in later life, which may be a precursor for Alzheimer’s disease. However, studies examining the potential mechanisms between ACEs and SCD as well as the differential role that gender might play in these pathways are lacking. The aim of this study was to assess how gender influences the association between ACEs, depression and SCD.MethodData were obtained from 14,630 respondents (6,254 men and 8,376 women) from the 2021 US Behavioral Risk Factor Surveillance System survey. Trauma was operationalized as the experience of ACEs. A depression categorization was based on respondents’ self‐report of ever being informed of having a depressive disorder. SCD was operationalized as respondents reporting having experienced increasing confusion or memory loss in the past 12 months. Crude and adjusted stratified path analyses using PROC CALIS were conducted to determine the direct and indirect associations between ACEs, depression, and SCD overall and by gender.ResultPreliminary analyses show that in the overall study population, respondents who reported experiencing ACEs were more likely to report depression (B = 0.165; p<0.0001) and those who reported a depression diagnosis were more likely to report SCD (B = 0.191; p<0.0001) in the past year. There was also a direct positive association between ACEs and SCD (B = 0.085, p<0.0001) where respondents with a history of ACEs were more likely to report SCD. Depression mediated the association between ACEs and SCD (B = 0.032; p<0.0001) Stratified path analyses showed similar findings for men and women where depression was a mediator in the relationship between ACEs and SCD (men: B = 0.025; p<0.0001; and women: B = 0.036; p<0.0001).ConclusionDepression mediated the association between ACEs and SCD in the overall population, and among men and women. There was no moderating role of gender in the mediational pathway between ACEs, depression and SCD. Further analyses will be conducted to elucidate the interaction effects in these data. Future studies should assess the moderating role of gender in alternative mediational pathways such as examining substance use, and PTSD as potential mediators in the relationship between ACEs and SCD.