Cognitive decline is a significant public health challenge in China. Childhood socioeconomic status has a lasting impact on later-life health, but the specific life-course pathways that link early-life adversity to later-life cognitive function remain unclear. This study aimed to examine the association between childhood economic and psychosocial conditions and later-life cognitive function in older Chinese adults, and additionally, whether social and health factors in adulthood influenced or accounted for this association. We analysed 10,950 participants from all waves of the China Health and Retirement Longitudinal Study (2011–2020). Early-life exposures were childhood economic indicators (parental occupation and perceived family financial status) and psychosocial indicators (childhood loneliness and parental relationships). Cognitive function was the dependent variable. We utilised multilevel growth curve models with random intercepts, random slopes, and quadratic age terms to estimate cognitive trajectories. A sequential modelling strategy evaluated whether adult social factors and health factors accounted for observed associations. The sample comprised 10,950 individuals with a mean age of 58.22 ± 8.90 years. In models adjusted only for age and sex, poorer childhood financial status was associated with lower cognitive function. However, after accounting for adult social and health factors, this association was substantially attenuated (reduced by 42%), though it remained statistically significant (β = -0.16, p = 0.023). Similarly, the protective effects of several early-life indicators were partially explained by adult-life pathways. In particular, the association for better childhood financial status was fully attenuated after adjustment. Nevertheless, having a father in non-agricultural employment (β = 0.74, p < 0.001) and not experiencing childhood loneliness (β = 0.33, p < 0.001) remained robustly associated with higher cognitive performance even in the fully adjusted model. Among adult factors, higher educational attainment (β = 3.80, p < 0.001), fewer Instrumental Activities of Daily Living limitations (β = -0.35, p < 0.001), and lower depressive symptom scores (β = -0.08, p < 0.001) were strongly associated with cognitive function. Childhood economic and psychosocial disadvantages have persistent, long-term effects on cognitive functioning in later life. These effects are substantially explained by adult life pathways, particularly educational attainment, physical frailty, and mental health. These findings suggest that interventions targeting both childhood adversity and adult-life risk factors may be effective in mitigating cognitive decline.
Le et al. (Fri,) studied this question.