Dementia Linked to Adverse Childhood Experiences

A tough upbringing could be a predictor to a dementia diagnosis later in life.

A team, led by Yukako Tani, PhD, Department of Global Health Promotion, Tokyo Medical and Dental University, examined the link between adverse childhood experiences and dementia for Japanese patients born before 1948.

The investigators found that having 3 or more adverse childhood experiences is linked to an increased dementia risk for older Japanese adults.

The prevalence of dementia in Japan has been increasing in recent years, with childhood poverty having increased the risk of cognitive impairment, possibly mediated by individuals’ educational paths.

However, the associations between dementia and adverse childhood experiences outside of poverty and education has not been well documented.

The investigators examined 17,412 older adults in a large-scale cohort study to identify the cumulative number of adverse childhood experiences linked to an increase in the risk of developing dementia.

The study included a 3-year follow-up between 2013-2016 for participants in the Japan Gerontological Evaluation Study, a population-based cohort study of adults at least 65 years old.

The investigators assessed dementia onset through the public long-term care insurance system. Adverse childhood experiences were also assessed, including parental death, parental divorce, parental mental illness, family violence, physical abuse, psychological neglect, and psychological abuse.

The team classified patients according to whether they had 0-3 or more adverse childhood experiences and used Cox regression models to estimate hazard ratios for the risk of dementia.

Early life exposure to adverse childhood experiences, including parental loss, family psychopathology, and child maltreatment, may be associated with dementia.

Of the 17,412 patients, 703 patients developed dementia during a mean follow-up of 3.2 years. A total of 6804 participants were older than 75 and 10,968 did not report an adverse childhood experience, while 5129 participants reported 1 adverse childhood experience, 964 individuals reported 2 childhood adverse experiences, and 351 participants reported 3 or more.

The patients that reported at least 3 adverse experiences had a greater risk of developing dementia compared to individuals who grew up without adverse childhood experiences after adjusting for age, sex, childhood economic hardship, nutritional environment, and education (HR, 2.18; 95% CI, 1.42-3.35).

“This study found that having 3 or more adverse childhood experiences was associated with increased dementia risk among older Japanese adults,” the authors wrote.

With the global population aging, dementia and other mental health issues associated with aging has become a major concern.

Approximately 47 million people had dementia in 2015 worldwide, with the number expected to triple by 2050.

With the numbers rising, investigators have called for more evidence-based prevention strategies.

Previous studies indicated that childhood poverty is associated with cognitive impairment, possibly mediated by individual’s educational path. However, the associations between dementia and adverse childhood experiences other than education and poverty are not well documented.

The study, “Association Between Adverse Childhood Experiences and Dementia in Older Japanese Adults,” was published online in JAMA Network Open.