ArticleBMJ open2023
What is the association between adverse childhood experiences and late-life cognitive decline? Study of Healthy Aging in African Americans (STAR) cohort study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Cognitive impairment and dementia-Are they linked to childhood health and socioeconomic status? A systematic review.PloS one · 2025Pooled it
- The long-term impact of adverse childhood experiences on episodic memory in mid- to late-life among US older adults.Aging & mental health · 2026Article
- Association of Adverse Childhood Experiences and Cognitive Health in Older Adults: Rush Memory and Aging Project.The American journal of geriatric psychiatry. Open science, education, and practice · 2026Article
- Associations of war-related exposures and early life adversity with late-life cognition.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Modeling the importance of life exposure factors on memory performance in diverse older adults: A machine learning approach.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- The link between traumatic experiences and health in late life: challenges and opportunities for US-based longitudinal aging cohorts.American journal of epidemiology · 2025Article
- Sex Differences in the Associations Among Early Life Adversity, Inflammation, and Cognition.Biomolecules · 2025Review
- Childhood adversity and late-life cognitive and brain health in a diverse cohort.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Adverse Childhood Experiences and Later-Life Cognitive Aging: Persistent Methodological Challenges Limit the Evidence Base.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesAdverse childhood experiences (ACEs) are associated with higher risk of chronic disease, but little is known about the association with late life cognitive decline. We examined the longitudinal association between ACEs and late-life cognitive decline in the Study of Healthy Aging in African Americans (STAR).
designLinear mixed models with random intercepts and slope examined the association of individual and composite ACEs with cognitive change adjusting for years from baseline (timescale), baseline age, sex, parental education, childhood socioeconomic status and childhood social support. Participants reported whether they had experienced nine types of ACEs. Executive function and verbal episodic memory were measured up to three times over a 3-year period using the Spanish and English Neuropsychological Assessment Scales. SETTINGS: Kaiser Permanente Northern California members living in the Bay Area.
participantsSTAR is a cohort study of cognitive ageing launched in 2018 that has enrolled 764 black Americans ages ≥50 years (mean age=67.5; SD=8.5).
resultsTwenty-one per cent of participants reported no ACEs, 24% one ACE, 20% two ACEs, 17% three ACEs and 17% four or more ACEs. Compared with no ACEs, two ACEs (β=0.117; 95% CI 0.052 to 0.182), three ACEs (β=0.075; 95% CI 0.007 to 0.143) and four or more ACEs (β=0.089; 95% CI 0.002 to 0.158) were associated with less decline in executive function. There were no significant associations between number of ACEs and baseline or longitudinal verbal episodic memory or between individual ACEs and executive function or verbal episodic memory.
conclusionIn this cohort of older black Americans, there was no association between ACEs and baseline cognition or cognitive change in verbal episodic memory; however, experiencing ≥ 2 ACEs was associated with less decline in executive function. These results may indicate that participants who survived to age 50+ and experienced ACEs may have cognitive resilience that warrants further investigation.
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