Adversity in childhood and measures of aging in midlife: Findings from a cohort of british women

From the early scars to the vicissitudes of old age: A bibliometric analysis revealing childhood adversity and aging

BACKGROUND

Adversity suffered in childhood may profoundly affect aging over the subsequent life cycle. The field of childhood adversity and aging has amassed a certain number of publications, but there are no bibliometric studies in this field.

METHODS

Publications in 10 years on childhood adversity and aging were searched in the Web of Science Core Collection. Bibliometric tools were used to analyze and visualize these publications by country, institution, journal, author, keyword, research area, and co-citation.

RESULTS

Four hundred thirty-five publications were retrieved from 2014 to September 21, 2023, with a 4.9% annual growth rate. The United States (251), University of California, San Francisco (59), Elissa S. Epel (11), and Psychoneuroendocrinology (29) were the countries, institutions, authors, and journals contributing the highest number of publications in this field, respectively. "Early-life stress" (87), "depression" (82), "childhood trauma" (69), and "aging" (60) were the keywords that appeared more frequently.

CONCLUSIONS

This is the first bibliometric study on childhood adversity and aging. The United States dominates the field regarding publication numbers, research institutions, and researchers. Publications in this field are interdisciplinary, covering several critical subject areas and having far-reaching impacts, with gerontology, neurosciences, psychology, and psychiatry at the core.

Mind versus body: Perceived stress and biological stress are independently related to cognitive decline

Chronic stress may increase risk of age-related cognitive decline. 'Stress', however, is a multidimensional construct and few studies have investigated the inter-relationship of subjective stress and biological stress with cognitive decline. In this study, we examine the relationship between perceived stress and two measures of biological stress - allostatic load, indexing stress at the physiological level and leukocyte telomere length, indexing stress at the cellular level - with cognitive decline over a 12-year period in adults aged 50 and older. 3,458 participants (aged ≥ 50) from The Irish Longitudinal study on Ageing with measurements of allostatic load, telomere length and perceived stress at baseline and repeated measures of cognitive function were included. Hierarchical linear regression models with adjustment for multiple potential confounders were applied, and repeated stratified by sex in sensitivity analyses. Higher perceived stress at baseline was associated with lower cognitive function (β = -0.10, 95 % CI -0.12, -0.07, p <.001), with similar strength of associations across waves. There were significant interactions between measures of biological stress and wave; higher allostatic load was associated (X2(18) = 64.4; p <.001), and telomere length was borderline (X2(18) = 9.4; p =.09) associated with cognitive decline from 4-year follow-up onward. Sex stratified analyses revealed that the association between telomere length and cognitive decline was present in women only. Mutual adjustment did not attenuate associations in either case. The interactions between allostatic load and telomere length with perceived stress were not significant. Our findings suggest that subjective measures of stress and biological metrics may be independently related to cognitive function over time in older adults, hinting at the potential for different underlying mechanisms.

Adverse Childhood Experiences and Aging-Associated Functional Impairment in a National Sample of Older Community-Dwelling Adults

BACKGROUND

Prior research on the health implications of adverse childhood experiences (ACEs) has focused on early or midlife adults, not older adults who bear the greatest burden of health-related functional impairment.

OBJECTIVE

To examine associations between ACEs, objectively measured physical mobility and cognitive impairment, and functional disability in older community-dwelling adults.

DESIGN

Cross-sectional analysis.

PARTICIPANTS

Community-dwelling older U.S. adults ages 50 years and older.

MAIN MEASURES

Participants completed structured questionnaires assessing history of ACEs (childhood experience of violence/abuse, witnessing of violence, financial insecurity, parental separation, or serious illness), underwent standardized physical performance testing (tandem balance, 3-m walk, chair stand test) and cognitive testing (survey adaptation of the Montreal Cognitive Assessment), and reported functional disability (difficulty with activities of daily living).

KEY RESULTS

Among the 3387 participants (aged 50 to 97 years; 54% female), 44% reported a history of one or more types of ACEs. Thirty-five percent met criteria for physical mobility impairment, 24% for cognitive impairment, and 24% for functional disability. After adjusting for age, gender, race, and ethnicity, participants reporting any ACE history were more likely to demonstrate physical mobility impairment (OR 1.30, 95% CI 1.11-1.52) and cognitive impairment (OR 1.26, 95% CI 1.03-1.54) and report functional disability (OR 1.69, 95% CI 1.38-2.07), compared to those with no ACE history. Childhood experience of violence was associated with greater physical mobility impairment (OR 1.38, 95% CI 1.11-1.71) and functional disability (OR 1.86, 95% CI 1.49-2.33).

CONCLUSIONS

Older adults with a history of ACEs are more likely to experience physical and cognitive functional impairment, suggesting that efforts to mitigate ACEs may have implications for aging-associated functional decline. Findings support the need for trauma-informed approaches to geriatric care that consider the potential role of early life traumatic experiences in shaping or complicating late-life functional challenges.

The ACE Index: mapping childhood adversity in England

Background

Studies of adults show that adverse childhood experiences (ACEs) are associated with health and social problems and are more common among people living in deprived areas. However, there is limited information about the geographical pattern of contemporary ACEs.

Methods

We used data from the police, social services, schools and vital statistics in England to calculate population rates of events that represent childhood adversity. We constructed an ‘ACE Index’ that summarizes the relative frequency of ACEs at local authority level, informed by the methods of the Index of Multiple Deprivation. We explored associations between the ACE Index and local characteristics in cross-sectional ecological analysis.

Results

The ACE Index was strongly associated with the proportion of children that live in income-deprived households (child poverty). In addition, the ACE Index was independently associated with higher population density and was higher in certain regions, particularly the north-east.

Conclusions

The association between ACEs and child poverty provides evidence of a process in which deprivation increases the risk of adverse experiences in childhood. The ACE Index can inform allocation of resources for prevention and mitigation of ACEs.

Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): a systematic review

BACKGROUND

'Adverse childhood experiences' (ACEs) are associated with increased risk of negative outcomes in later life: ACEs have consequently become a policy priority in many countries. Despite ACEs being highly socially patterned, there has been very little discussion in the political discourse regarding the role of childhood socioeconomic position (SEP) in understanding and addressing them. The aim here was to undertake a systematic review of the literature on the relationship between childhood SEP and ACEs.

METHODS

MEDLINE, PsycINFO, ProQuest and Cochrane Library databases were searched. Inclusion criteria were: (1) measurement of SEP in childhood; (2) measurement of multiple ACEs; (3) ACEs were the outcome; and (4) statistical quantification of the relationship between childhood SEP and ACEs. Search terms included ACEs, SEP and synonyms; a second search additionally included 'maltreatment'. Overall study quality/risk of bias was calculated using a modified version of the Hamilton Tool.

RESULTS

In the ACEs-based search, only 6 out of 2825 screened papers were eligible for qualitative synthesis. The second search (including maltreatment) increased numbers to: 4562 papers screened and 35 included for synthesis. Eighteen papers were deemed 'high' quality, five 'medium' and the rest 'low'. Meaningful statistical associations were observed between childhood SEP and ACEs/maltreatment in the vast majority of studies, including all except one of those deemed to be high quality.

CONCLUSION

Lower childhood SEP is associated with a greater risk of ACEs/maltreatment. With UK child poverty levels predicted to increase markedly, any policy approach that ignores the socioeconomic context to ACEs is therefore flawed.

PROSPERO REGISTRATION NUMBER

CRD42017064781.

Childhood adversity and DNA methylation in two population-based cohorts

Childhood adversity affects later health, but the underlying molecular mechanisms are unclear. Although there is some evidence from animal models and case-control studies of a role for DNA methylation, evidence from human population-based studies is limited. In two cohorts (mothers from the Avon Longitudinal Study of Parents and Children, ALSPAC, n = 780 and women from the MRC National Survey of Health and Development, NSHD, n = 552), we assessed the association of seven adverse childhood experiences (ACEs: parental physical illness, parental mental illness, parental death, parental separation, suboptimal maternal bonding, childhood illness and child maltreatment) as well as their combination (ACE score) with genome-wide DNA methylation levels measured using the Illumina Infinium HumanMethylation450 BeadChip in peripheral blood at mean age 47 years (ALSPAC) and in buccal cells at age 53 years (NSHD). CpG sites with a genome-wide false discovery rate (FDR) below 0.05 and differentially methylated regions (DMRs) with one-step Šidák correction p-values below 0.05 in each cohort were examined in the other cohort. No individual CpG sites replicated across cohorts. However, nine DMRs replicated across cohorts respectively associated with the ACE score (one region), parental mental illness (two regions), parental physical illness (three regions) and parental death (three regions). These observations indicate that some adverse childhood experiences, notably those related to parental health, may leave imprints on peripheral DNA methylation that persist to mid-life.

Childhood socioeconomic status and genetic risk for poorer cognition in later life

The ε4 allele of the APOE gene is associated with poorer cognition in later life. This study aimed to advance understanding of how environments potentially moderate this genetic risk by focusing on childhood socioeconomic status (SES). Previous research across diverse national contexts has found that older adults from higher-SES families in childhood demonstrate better cognitive functioning than their lower-SES counterparts. Nevertheless, few studies have examined whether higher childhood SES might also promote later life cognition by mitigating the effects of ε4 carrier status. To address this gap, we used data from 3017 participants in the Wisconsin Longitudinal Study, which has followed a random sample of people who graduated from Wisconsin high schools in 1957. Childhood SES included parents' educational attainment, father's occupational status, and household income in adolescence. We constructed measures of memory and of language/executive functioning using scores from neurocognitive tests administered when participants were approximately ages 65 and 72. APOE ε4 status was measured through saliva samples. Results from cross-controlled multilevel models indicated that APOE ε4 status-and not childhood SES-independently predicted memory, whereas childhood SES-and not APOE ε4 status-independently predicted language/executive functioning. Moreover, a statistical interaction between APOE ε4 status and childhood SES for memory indicated that at baseline, higher childhood SES protected against the risk of APOE ε4 status, whereas lower childhood SES exacerbated the risk of APOE ε4 status. However, by follow-up, these moderating effects dissipated, and APOE ε4 status alone was associated with memory. We interpret these results in light of theorizing on differential susceptibility for poorer cognition across the life course.