Top

Social Psychiatry and Psychiatric Epidemiology

Open Access 08-05-2024 | Dementia | Research

Adverse childhood experiences and risk of late-life dementia: a systematic review and meta-analysis

Authors: Moaz Elsayed Abouelmagd, Maickel AbdelMeseh, Amr Elrosasy, Hatem Abdelmoneim Eldeeb, Yehia Nabil

Published in: Social Psychiatry and Psychiatric Epidemiology

Abstract

Background

Adverse childhood experiences (ACEs) refer to distressing events before age 18 that can lead to potential mental and physical health consequences. This systematic review and meta-analysis aimed to examine the association between ACEs and the risk of dementia in elderly adults who experienced ACEs during childhood, addressing the existing inconsistencies and methodological variations.

Methods

A comprehensive search strategy was employed across key databases (PubMed, Web of Science, Scopus, and Embase) to identify relevant articles. Our primary outcome was ACEs-dementia risk, and our secondary outcome was mild cognitive impairment risk. A quality assessment was conducted using the Newcastle–Ottawa Quality Assessment Scale and GRADE. A random-effects model was utilized to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were performed to explore potential sources of heterogeneity and assess the reliability of the results.

Results

Out of 1,376 screened papers, nine studies were included. The studies consisted of two case-control, one prospective cohort, and six retrospective cohort studies conducted in the UK, France, USA, China, and Spain. Five studies were of good methodological quality according to the NOS. according to the GRADE, all outcomes were classified as very low or low quality of evidence. A significant association was observed between ACEs and dementia risk (OR = 1.35; 95% CI 1.20, 1.52; P = 0.00001) and mild cognitive impairment risk (OR = 1.28; 95% CI 0.63, 2.62; P = 0.49). A meta-analysis by type of adversity revealed significant results for the maltreatment subgroup(OR = 1.30; 95% CI 0.07-1.58; P = 0.007; I² = 0%). Subgroup analysis based on the dementia definition revealed no between-subgroup difference (P = 0.71) between tool-based and register/criteria-based subgroups. No possibility of Publication bias was observed upon inspection of the funnel plot.

Conclusion

Adverse childhood experiences may be associated with an increased risk of dementia. However, caution is warranted in interpreting these results due to the limited number of studies. Larger high-quality studies investigating the association between ACEs and dementia risk are needed to confirm the reliability of our results.

Available only for authorised users

Hillis S, Mercy J, Amobi A, Kress H (2016) Global prevalence of past-year violence against children: a systematic review and minimum estimates. Pediatrics 137(3):e20154079. https://doi.org/10.1542/peds.2015-4079CrossRefPubMed

Bellis MA, Hughes K, Ford K, Rodriguez GR, Sethi D, Passmore J (2019) Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis. Lancet Public Health 4:e517–e28CrossRefPubMedPubMedCentral

Lorenc T, Lester S, Sutcliffe K et al (2020) Interventions to support people exposed to adverse childhood experiences: a systematic review of systematic reviews. BMC Public Health 20:657. https://doi.org/10.1186/s12889-020-08789-0CrossRefPubMedPubMedCentral

Alzheimer’s Disease International (2024) World Alzheimer Report 2015: the Global Impact of Dementia. An Analyses of Prevalence, incidence, Cost and Trends. https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf. Accessed February 20

Lupien SJ, McEwen BS, Gunnar MR, Heim C (2009) Effects of stress throughout the lifespan on the brain, behavior, and cognition. Nat Rev Neurosci 10(6):434–445CrossRefPubMed

Richards M, Wadsworth ME (2004) Long-term effects of early adversity on cognitive function. Arch Dis Child 89(10):922–927CrossRefPubMedPubMedCentral

Günak MM, Billings J, Carratu E, Marchant NL, Favarato G, Orgeta V (2020) Post-traumatic stress disorder as a risk factor for dementia: systematic review and meta-analysis. Br J Psychiatry: J Mental Sci 217(5):600–608. https://doi.org/10.1192/bjp.2020.150CrossRef

Webster EM (2022) The impact of adverse childhood experiences on health and development in young children. Global Pediatr Health 9:1–11. https://doi.org/10.1177/2333794X221078708CrossRef

Widom CS, Do HH, Lynch KS, Manly JJ (2023) Childhood maltreatment and dementia risk factors in midlife: a prospective investigation. Curr Alzheimer Res Published Online Dec 28. https://doi.org/10.2174/0115672050281539231222071355

10.

Corney KB, West EC, Quirk SE, Pasco JA, Stuart AL, Manavi BA, Kavanagh BE, Williams LJ (2022) The relationship between adverse childhood experiences and Alzheimer’s Disease: a systematic review. Front Aging Neurosci 14:831378. https://doi.org/10.3389/fnagi.2022.831378PMID: 35601624; PMCID: PMC9115103CrossRefPubMedPubMedCentral

11.

Patel P, Oremus M (2023) The Association between adverse childhood experiences and late-life cognition: a systematic review of cross-sectional and case-control studies. Gerontologist 63(6):1087–1103. https://doi.org/10.1093/geront/gnac041CrossRefPubMed

12.

Mourad Ouzzani H, Hammady Z, Fedorowicz, Ahmed Elmagarmid (2016) Rayyan — a web and mobile app for systematic reviews. Syst Reviews 5:210. https://doi.org/10.1186/s13643-016-0384-4CrossRef

13.

Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P (2012) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Retrieved from http://wwwohrica/programs/clinicalepidemi

14.

Viswanathan M, Ansari MT, Berkman ND, Chang S, Hartling L, McPheeters LM (2012) Assessing the risk of bias of individual studies in systematic reviews of health care interventions. Agency for Healthcare Research and Quality Methods Guide for Comparative Effectiveness Reviews. March 2012. AHRQ Publication No. 12-EHC047-EF. Retrieved from https://effectivehealthcare.ahrq.gov/

15.

Schünemann HJ, Higgins JPT, Vist GE, Glasziou P, Akl EA, Skoetz N, Guyatt GH (2022) Chapter 14: Completing ‘Summary of findings’ tables and grading the certainty of the evidence. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane, www.training.cochrane.org/handbook

16.

Xie Z, Li M, Sun H et al (2023) Childhood, adulthood, and cumulative traumatic experiences experienced from childhood to adulthood and dementia risk: a population-based cohort study. J Public Health (Berl). https://doi.org/10.1007/s10389-023-02140-8CrossRef

17.

Nilaweera D, Freak-Poli R, Gurvich C, Ritchie K, Chaudieu I, Ancelin ML, Ryan J (2022) The association between adverse childhood experiences and later-life cognitive function and dementia risk. J Affect Disord 304:128–132. https://doi.org/10.1016/j.jad.2022.02.062CrossRefPubMed

18.

Yuan M, Qin F, Xu C, Fang Y (2022) Heterogeneous adverse childhood experiences and cognitive function in an elderly Chinese population: a cohort study. BMJ open 12(6):e060477. https://doi.org/10.1136/bmjopen-2021-060477CrossRefPubMedPubMedCentral

19.

Roberts AL, Zafonte R, Chibnik LB, Baggish A, Taylor H, Baker J, Whittington AJ, Weisskopf MG (2022) Association of Adverse Childhood Experiences with Poor Neuropsychiatric Health and Dementia among former Professional US Football players. JAMA Netw open 5(3):e223299. https://doi.org/10.1001/jamanetworkopen.2022.3299CrossRefPubMedPubMedCentral

20.

Macpherson JM, Gray SR, Ip P, McCallum M, Hanlon P, Welsh P, Chan KL, Mair FS, Celis-Morales C, Minnis H, Pell JP, Ho FK (2021) Child maltreatment and incident mental disorders in middle and older ages: a retrospective UK Biobank cohort study. Lancet Reg Health Eur 11:100224. https://doi.org/10.1016/j.lanepe.2021.100224PMID: 34917999; PMCID: PMC8642708CrossRefPubMedPubMedCentral

21.

Conde-Sala JL, Garre-Olmo J (2020) Early parental death and psychosocial risk factors for dementia: a case-control study in Europe. Int J Geriatr Psychiatry 35(9):1051–1059. https://doi.org/10.1002/gps.5328CrossRefPubMed

22.

Donley GAR, Lönnroos E, Tuomainen TP, Kauhanen J (2018) Association of childhood stress with late-life dementia and Alzheimer’s disease: the KIHD study. Eur J Pub Health 28(6):1069–1073. https://doi.org/10.1093/eurpub/cky134CrossRef

23.

Wang L, Yang L, Yu L, Song M, Zhao X, Gao Y, Han K, An C, Xu S, Wang X (2016) Childhood physical neglect promotes development of mild cognitive impairment in old age - a case-control study. Psychiatry Res 242:13–18. https://doi.org/10.1016/j.psychres.2016.04.090CrossRefPubMed

24.

Pilleron S, Guerchet M, Ndamba-Bandzouzi B, Mbelesso P, Dartigues JF, Preux PM, Clément JP (2015) Association between Stressful Life experiences and Cognitive disorders in Central Africa: results from the EPIDEMCA Program. Neuroepidemiology 44(2):99–107. https://doi.org/10.1159/000375462CrossRefPubMed

25.

Merrick MT, Ford DC, Ports KA et al (2019) Vital signs: estimated proportion of adult health problems attributable to adverse childhood experiences and implications for Prevention – 25 states, 2015–2017. MMWR Morb Mortal Wkly Rep 68(44):999–1005 Published 2019 Nov 8. https://doi.org/10.15585/mmwr.mm6844e1CrossRefPubMedPubMedCentral

26.

Trivedi GY, Pillai N, Trivedi RG (2021) Adverse Childhood Experiences & Mental Health - the urgent need for public health intervention in India. J Prev Med Hyg 62(3):E728–E735. https://doi.org/10.15167/2421-4248/jpmh2021.62.3.1785PMID: 34909501; PMCID: PMC8639107

27.

Glaesmer H, Schulz A, Häuser W, Freyberger HJ, Brähler E, Grabe HJ (2013) Der Childhood Trauma Screener (CTS) - Entwicklung und Validierung von Schwellenwerten zur Klassifikation [The childhood trauma screener (CTS) - development and validation of cut-off-scores for classificatory diagnostics] [published correction appears in Psychiatr Prax. ;40(4):e1]. Psychiatr Prax. 2013;40(4):220–226. https://doi.org/10.1055/s-0033-1343116

28.

Bernstein DP, Stein JA, Newcomb MD et al (2003) Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl 27(2):169–190. https://doi.org/10.1016/s0145-2134(02)00541-0CrossRefPubMed

29.

Liebschutz JM, Buchanan-Howland K, Chen CA et al (2018) Childhood trauma questionnaire (CTQ) correlations with prospective violence assessment in a longitudinal cohort. Psychol Assess 30(6):841–845. https://doi.org/10.1037/pas0000549CrossRefPubMedPubMedCentral

30.

Emily M, Zarse MR, Neff R, Yoder L, Hulvershorn, Joanna E, Chambers & R. Andrew Chambers | Udo Schumacher (reviewing editor) (2019) the adverse childhood experiences questionnaire: two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases. Cogent Med, 6:1, https://doi.org/10.1080/2331205X.2019.1581447

31.

Hardt J, Rutter M (2004) Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry 45(2):260–273. https://doi.org/10.1111/j.1469-7610.2004.00218.xCrossRefPubMed

32.

Webster EM (2022) The impact of adverse childhood experiences on Health and Development in Young Children. Global Pediatr Health 9. https://doi.org/10.1177/2333794X221078708

33.

Merrick MT, Ports KA, Ford DC, Afifi TO, Gershoff ET, Grogan-Kaylor A (2017) Unpacking the impact of adverse childhood experiences on adult mental health. Child Abuse Negl 69:10–19. https://doi.org/10.1016/j.chiabu.2017.03.016CrossRefPubMedPubMedCentral

34.

Tan M, Mao P (2023) Type and dose-response effect of adverse childhood experiences in predicting depression: a systematic review and meta-analysis. Child Abuse Negl 139:106091. https://doi.org/10.1016/j.chiabu.2023.106091CrossRefPubMed

35.

Baldwin JR, Reuben A, Newbury JB, Danese A (2019) Agreement between prospective and retrospective measures of Childhood Maltreatment: a systematic review and Meta-analysis. JAMA Psychiatry 76(6):584–593. https://doi.org/10.1001/jamapsychiatry.2019.0097CrossRefPubMedPubMedCentral

36.

Francis ER, Tsaligopoulou A, Stock SE, Pingault JB, Baldwin JR (2023) Subjective and objective experiences of childhood adversity: a meta-analysis of their agreement and relationships with psychopathology. J Child Psychol Psychiatry 64(8):1185–1199. https://doi.org/10.1111/jcpp.13803CrossRefPubMedPubMedCentral

Title: Adverse childhood experiences and risk of late-life dementia: a systematic review and meta-analysis
Authors: Moaz Elsayed Abouelmagd
Maickel AbdelMeseh
Amr Elrosasy
Hatem Abdelmoneim Eldeeb
Yehia Nabil
Publication date: 08-05-2024
Publisher: Springer Berlin Heidelberg
Keywords: Dementia
Dementia
Mild Neurocognitive Disorder
Published in: Social Psychiatry and Psychiatric Epidemiology
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-024-02676-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Adverse childhood experiences and risk of late-life dementia: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content