Adverse childhood experiences and their impacts on subsequent depression and cognitive impairment in Chinese adults

Abstract

Background: Adverse childhood experiences (ACEs) are prevalent and have long lasting effects. This study aimed to explore the associations between ACEs exposure with subsequent depression and cognitive impairment and to assess whether sociodemographic characteristics modify these associations. Method: A total of 14,484 participants from the China Health and Retirement Longitudinal Study (CHARLS) 2015 and life history survey in 2014 were enrolled. Depression was assessed by the 10-item Center for Epidemiologic Studies Depression scale. Cognitive performance was evaluated by three composite measures: episodic memory, mental intactness and global cognition. A wide range of 12 ACE indicators were measured by a validated questionnaire. Multiple regression models and stratified analysis explore the relationship between accumulated ACEs with subsequent depression and cognitive impairment and potential modifiers. Results: Compared with individuals without ACEs, those who experienced four or more ACEs have a higher risk of subsequent depression (adjusted odds ratio, aOR=2.65, 95% confidence intervals [CIs]: 2.21-3.16), poorer mental intactness (β= -0.317 [-0.508 to -0.125]) and worse global cognition (β= -0.437 [-0.693 to -0.181]). Trend analyses showed a dose-response association between accumulated ACEs with subsequent depression and cognitive impairment. The modifications of the association by age, sex, educational level and family's financial status during childhood were not observed. Conclusion: Our study suggests that higher ACEs exposure increases the risk of subsequent depression and cognitive impairment in Chinese adults regardless of sociodemographic characteristics. The findings provide important implications for mitigating the adverse effects of early-life stress and promoting health in adulthood.