Introduction
Much of the heterogeneity in the rate of cognitive decline and the age of dementia
onset remains unexplained, and there is compelling data supporting psychosocial stressors
as important risk factors. However, the literature has yet to come to a consensus
on whether there is a causal relationship and, if there is, its direction and strength.
This study estimates the relationship between lifecourse traumatic events and cognitive
trajectories and predicted dementia incidence.
Methods
Using data on 7,785 participants aged ≥65 years from the Health and Retirement Study,
this study estimated the association between lifecourse experience of 10 traumatic
events (e.g., losing a child) and trajectories of Telephone Interview for Cognitive
Status from 2006 to 2016 using linear mixed-effects models and predicted incident
dementia from 2006 to 2014 using cumulative incidence functions (data analysis was
in 2020–2022). Inverse probability weights accounted for loss to follow-up and confounding
by sex, education, race/ethnicity, and age.
Results
Experiencing 1 or more traumatic events over the lifecourse was associated with accelerated
decline compared with experiencing no events (e.g., β= −0.05 [95% CI= −0.07, −0.02]
Health and Retirement Study-Telephone Interview for Cognitive Status units/year; 1
vs 0 events). In contrast, experiencing traumatic events was associated with better
cognitive function cross-sectionally. Furthermore, the impact of trauma on cognitive
decline was of greater magnitude when it occurred after the age of 64 years. However,
the magnitude and direction of association varied by the specific traumatic event.
There were no associations with predicted incident dementia.
Conclusions
These results suggest that researchers and clinicians should not aggregate traumatic
events for understanding the risk of accelerated cognitive decline.
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Article Info
Publication History
Published online: July 04, 2022
Publication stage
In Press Journal Pre-ProofIdentification
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© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
