Associations of adverse childhood experiences and social vulnerability with a diagnosis of cognitive impairment or dementia
Bibliographic record
Abstract
BACKGROUND: Adverse childhood experiences and social vulnerability in adulthood are associated with poorer health outcomes including cognitive impairment and dementia. One proposed mechanism linking adverse childhood experiences with later development of dementia is the association with other known social risk factors such as lower education. Here, we consider the association of social vulnerability, a comprehensive measure of social risk factors, and adverse childhood experiences with a clinical diagnosis of cognitive impairment or dementia. METHOD: We analyzed data from 949 participants in the COMPASS-ND study of neurodegenerative disorders. Social vulnerability was measured using a deficit accumulation approach resulting in a 49-item social vulnerability index (SVI). Early childhood experience was assessed using the Adverse Childhood Experiences Questionnaire and participants were grouped into 0, 1-2, and 3 or more adverse childhood experiences. Multinomial logistic regression was used to examine associations between adverse childhood experiences and social vulnerability with clinical diagnosis (i.e., dementia, mild cognitive impairment (MCI), and subjective cognitive impairment (SCI) compared to cognitively unimpaired). Models included adverse childhood experiences, the SVI, and were adjusted for age, education, and an 81-item frailty index. Analyses were conducted separately for each sex with clinical diagnosis as the outcome. RESULTS: Ages ranged from 42-90 years (M=72, SD=7.3) and 48.3% were female. For females, there was no statistically significant association between adverse childhood experience and diagnoses. Every 0.1 difference in the SVI was associated with higher odds of MCI (OR = 1.41, 95%CI=1.11-1.80) and SCI (OR=1.53, 95%CI=1.18-1.98) compared to cognitively unimpaired females. For males, neither adverse childhood events nor social vulnerability had a statistically significant association with diagnoses. CONCLUSION: Being more socially vulnerable as an adult is associated with higher odds of experiencing mild or subjective cognitive impairment in females. As this is a cross-sectional study, we do not know the direction of the association and it is likely bi-directional to some degree. Strategies for reducing social vulnerability may also provide bi-directional benefits in improving the lives of females who have cognitive impairment and providing some protection against cognitive decline.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 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".