Early life adversities have been associated with a variety of negative outcomes, including risk for mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, knowledge about the relationship between childhood adversities ? particularly child abuse and neglect ? and cognitive decline and functioning in adulthood is limited. Existing research relies heavily on cross-sectional studies and retrospective self-reports of childhood maltreatment. While the results of these studies are suggestive, conclusive evidence linking verified child maltreatment and cognitive decline and AD does not exist, a significant gap in the literature. Reliance on retrospective self-reports, particularly with an aging or aged population, leads to questions about the reliability and validity of that information. The proposed research seeks to: (1) determine whether cognitive decline is more rapid in adults with documented maltreatment histories and whether they are at increased risk for MCI and AD; (2) examine two hypothesized pathways from child maltreatment to increased risk for MCI/AD through (a) physical health and psychosocial risk factors and (b) biological markers; (3) examine potential modifiable and non-modifiable risk factors that may protect maltreated children from risk for MCI/AD; and (4) compare risk for MCI/AD using both prospective and retrospective reports of child maltreatment and determine the reliability and validity of retrospective reports in an aging sample. Capitalizing on a unique prospective longitudinal study, the proposed research will use existing and newly collected data from a large sample of well-characterized, high-risk individuals that have been studied for over 30 years. This research has a number of important methodological advantages that overcome many of the limitations of previous research; (1) long term follow-up (estimated mean age 59 in 2020); (2) documented cases of child abuse and neglect; (3) a control group of children who were matched to the documented cases on the basis of age, sex, race/ethnicity, and approximate family social class at the time of the childhood abuse and neglect; (4) high rates of known risk factors for MCI/AD in both groups; (5) prospective longitudinal design that permits disentangling of issues of etiology and temporal sequence; (6) a diverse sample, including males, females, Blacks, and Whites; (7) participants and interviewers have been blinded to the purpose of the study, avoiding issues of bias; and (8) data on mediators has already been collected over several time points. The new data collection will include a neuropsychological battery using components of the NIH toolbox and NACC Uniform Data Set, a blood draw to determine APOE ?4 allele, epigenetic age, telomere length and immune function, assessment of attitudes towards aging and re-assessment of previous indicators, and retrospective self-reports of child maltreatment. The proposed research is more cost effective and feasible than designing a new prospective longitudinal study with these elements. This study will also generate a data archive that would be available for collaborative investigations of the effects of child maltreatment on cognitive decline and risk for MCI and AD.
Child abuse and neglect and cognitive decline, Mild Cognitive Impairment (MCI), and Alzheimer's Disease (AD) are all serious public health concerns that affect millions of children and adults each year and yet little is known about the consequences of child maltreatment for cognitive decline and aging. Capitalizing on a unique prospective longitudinal study of a large group of maltreated and non-maltreated children followed up into adulthood, the proposed research will shed light on whether individuals exposed to this particular childhood adversity are at increased risk for cognitive decline, MCI, and AD and identify biological and other health and psychosocial pathways from child maltreatment to increased risk for MCI and AD. Finally, by identifying potential moderating factors, the proposed research will provide clues to intervention strategies and targets to improve the health and well being of older Americans.
