Introduction
This study investigated whether individual-level social capital modifies the association
between adverse childhood experiences and dementia onset.
Methods
A 3-year follow-up (2013–2016) was conducted among participants who were physically
and cognitively independent in the Japan Gerontological Evaluation Study. Dementia
incidence for 16,821 participants was assessed through the public long-term care insurance
system. Adverse childhood experiences before age 18 years and social capital were
assessed using a self-report questionnaire at baseline in 2013. A total of 7 adverse
childhood experiences were assessed: parental death, parental divorce, parental mental
illness, family violence, physical abuse, psychological neglect, and psychological
abuse. To assess social capital's mediating effect, 3 individual social capital items
were measured (community trust, reciprocity, and attachment). The overall social capital
score was categorized as low (<10th percentile), middle (10th–90th percentile), or
high (>90th percentile). Data were analyzed in 2020.
Results
During the 3-year follow-up, 652 dementia cases occurred. Those with more adverse
childhood experiences had a greater risk of dementia. Stratification by social capital
score showed that the hazard ratio of ≥3 adverse childhood experiences (versus none)
was 3.25 (95% CI=1.73, 6.10) among those with low social capital and 1.19 (95% CI=0.58,
2.43) among those with middle social capital. Among those with ≥3 adverse childhood
experiences and high social capital, no dementia cases were observed.
Conclusions
Among older adults in Japan, adverse childhood experiences were associated with increased
dementia incidence only for those with low social capital.
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Article Info
Publication History
Published online: May 10, 2021
Identification
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
