The association of adverse childhood experiences and life course relationship quality with late-life cognitive health: Moderation by race/ethnicity and gender

BackgroundAdverse childhood experiences (ACEs) may increase Alzheimer's disease risk. How particular ACEs differentially relate to cognition and what role life course relationship quality (LCRQ) plays are unclear.ObjectiveAssess how ACEs subgroups relate to cognition and whether associations are impacted by LCRQ.MethodsAdults (ages 50-64 at baseline) from the Health and Retirement Study participated (n = 3225; 2006/2008 = baseline; 2018/2020 = follow-up). Latent class and profile analyses identified ACEs and LCRQ subgroups, respectively. Linear and multinomial logistic regressions related ACEs and LCRQ subgroups to global cognition, cognitive impairment, not dementia (CIND), and dementia at follow-up.ResultsWe identified 4 ACEs (High Adversity, Family Disruptions, Elevated Household Trauma, Low Adversity) and 3 LCRQ ("Strong", "Mixed", "Weak" Ties) classes. Racially/ethnically minoritized adults were more likely to belong to Family Disruptions and Weak Ties classes than White adults. Participants with Family Disruptions (versus Low Adversity) had worse cognition (global: b = -0.78, 95% CI -1.19;-0.37; CIND: RRR = 1.50, 95% CI 1.13;1.99); controlling for LCRQ and sociodemographics attenuated associations. Participants with Weak Ties (versus Strong) had worse cognition (global: b = -2.90, 95% CI -3.53;-2.26; CIND: RRR = 3.16, 95% CI 2.12;4.70; dementia: RRR = 3.64, 95% CI 1.92;6.90); associations were not explained by covariates.ConclusionsFamily Disruptions negatively impacted cognition, but associations were attenuated by sociodemographics. Assessing life course resources as contributors to resilience may help explain the untenable ACEs-cognition association. However, negative LCRQ was consistently harmful to cognition. Targeting life course social relationships may benefit cognition.