Early life factors and dementia risk: A study of adverse childhood experiences and later‐life cognition and behavior
Bibliographic record
Abstract
Abstract Background Of the 12 modifiable dementia risk factors established by the Lancet Commission, only one addresses early life. However, the brain is highly plastic in early life. Adverse childhood experiences (ACE)–physical, emotional, and sexual abuse and neglect–can result in long‐term reductions in brain volume. These alterations increase susceptibility to neurodegenerative diseases like Alzheimer’s disease. We investigated associations between the severity of ACE and cognitive and behavioral risk for dementia, operationalized as later‐life cognitive impairment and mild behavioral impairment (MBI), respectively. Method Data were from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behavior, Function, and Caregiving in Aging (CAN‐PROTECT) study. Measures included the Childhood Trauma Screener (for ACE), neuropsychological tests (objective cognition), Everyday Cognition (ECog)‐II (subjective cognition), and the MBI Checklist (MBI‐C, later‐life behavioral changes). Linear regressions modeled associations between ACE severity and neuropsychological test scores. Multivariable negative binomial regressions (zero‐inflated, if appropriate) modeled associations between ACE severity and ECog‐II and MBI‐C scores. Models adjusted for age, sex, education, and ethnocultural origin. Clinical diagnosis of depression and/or anxiety were explored as covariates and mediators of the observed associations. Result Participants (n = 1102) were 64.6 (SD = 7.3) years old; 883 (80.1%) were female, 290 (26.3%) had a bachelor’s degree or equivalent, and 939 (85.2%) were of European origins. Every 1 standard deviation (SD) increase in ACE score was associated with worse performance on Trail Making B (b = 0.10, 95%CI:0.05–0.16), Switching Stroop (b = ‐0.08, 95%CI:‐0.14—0.03), Paired Associates Learning (b = ‐0.08, 95%CI:‐0.13—0.02), and Digit Span (b = ‐0.08, 95%CI:‐0.14—0.02). Every 1 SD increase in ACE score was associated with higher ECog‐II (b = 1.1, 95%CI:1.0‐1.1, p = 0.007) and MBI‐C (b = 1.2, 95%CI:1.1–1.3, p<0.001) scores, not mediated by previous psychiatric history (ECog II p = 0.16; MBI‐C p = 0.13). Conclusion Greater ACE severity predicted more later‐life cognitive and behavioral symptoms, representing higher dementia risk, not mediated by psychiatric history. These findings extend the public health importance of ACE to brain aging and emphasize the importance of incorporating early‐life risk factors into dementia risk assessment. ACE are potential targets for risk reduction and identify persons who should be screened for cognitive and behavioral risk markers.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".