Adverse childhood experiences and their impacts on subsequent depression and cognitive impairment in Chinese adults: A nationwide multi-center study

Tiantian Zhang; Lena Kan; Changbo Jin; Wenming Shi

doi:10.1016/j.jad.2022.12.058

Adverse childhood experiences and their impacts on subsequent depression and cognitive impairment in Chinese adults: A nationwide multi-center study

J Affect Disord. 2023 Feb 15:323:884-892. doi: 10.1016/j.jad.2022.12.058. Epub 2022 Dec 22.

Authors

Tiantian Zhang¹, Lena Kan², Changbo Jin³, Wenming Shi⁴

Affiliations

¹ School of Social Development and Public Policy, Fudan University, Shanghai, China; Fudan University Center for Population and Development Policy Studies, Fudan University, Shanghai, China; Fudan Institute on Ageing, Fudan University, Shanghai, China.
² Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
³ Tongji University School of Medicine, Shanghai, China. Electronic address: changbojin@126.com.
⁴ Fudan University, Shanghai, China. Electronic address: shiwmfd@126.com.

PMID: 36566934
DOI: 10.1016/j.jad.2022.12.058

Abstract

Background: Adverse childhood experiences (ACE_S) are prevalent and have long-lasting effects. This study explored how ACE exposure is associated with subsequent depression and cognitive impairment and whether sociodemographic characteristics modify that association.

Method: This study used data on 14,484 participants of the 2015 China Health and Retirement Longitudinal Study (CHARLS) and 2014 CHARLS life history survey. Depression was assessed using the 10-item Center for Epidemiologic Studies Depression scale. Cognitive performance was evaluated via three composite measures: episodic memory, mental intactness, and global cognition. Twelve ACE indicators were measured using a validated questionnaire. Multiple regression models and stratified analyses explored the relationship between ACE_S and subsequent depression and cognitive impairment, as well as potential modifiers.

Results: Compared with individuals without ACE_S, those who experienced four or more ACE_S had a higher risk of subsequent depression (adjusted odds ratio, aOR = 2.65, 95 % confidence intervals [CIs]: 2.21 to 3.16), poorer mental intactness (β = -0.317 [-0.508 to -0.125]), and worse global cognition (-0.437 [-0.693 to -0.181]). Trend analyses showed a dose-response association between accumulated ACE_S and subsequent depression and cognitive impairment. No modifications of those associations by age, sex, educational level, or family's financial status during childhood were observed.

Limitations: Self-reported measures could favour recall bias.

Conclusion: Our study suggests that ACE_S increase the risk of subsequent depression and cognitive impairment in Chinese adults regardless of sociodemographic characteristics. These findings provide important implications for mitigating the adverse effects of early-life stress and promoting health in adulthood.

Keywords: Adults; Adverse childhood experiences; Cognitive impairment; Depression; Physical abuse.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Adverse Childhood Experiences*
Cognitive Dysfunction* / epidemiology
Cognitive Dysfunction* / etiology
Depression / epidemiology
Depression / psychology
East Asian People
Humans
Longitudinal Studies