Dataset Information

Are adverse childhood experiences associated with late-life cognitive performance across racial/ethnic groups: results from the Kaiser Healthy Aging and Diverse Life Experiences study baseline.

ABSTRACT:

Objectives

Evidence on adverse childhood experiences (ACEs) and late-life cognitive outcomes is inconsistent, with little research among diverse racial/ethnic groups. We investigated whether ACE exposures were associated with worse late-life cognition for all racial/ethnic groups and at different ages of exposure.

Design

Covariate-adjusted mixed-effects linear regression models estimated associations of: (1) total number of ACEs experienced, (2) earliest age when ACE occurred and (3) type of ACE with overall cognition.

Setting

Kaiser Permanente Northern California members aged 65 years and older, living in Northern California.

Participants

Kaiser Healthy Aging and Diverse Life Experiences study baseline participants, aged 65 years and older (n=1661; including 403 Asian-American, 338 Latino, 427 Black and 493 white participants).

Results

Most respondents (69%) reported one or more ACE, most frequently family illness (36%), domestic violence (23%) and parental divorce (22%). ACE count was not adversely associated with cognition overall (β=0.01; 95% CI -0.01 to 0.03), in any racial/ethnic group or for any age category of exposure. Pooling across all race/ethnicities, parent's remarriage (β=-0.11; 95% CI -0.20 to -0.03), mother's death (β=-0.18; 95% CI -0.30 to -0.07) and father's death (β=-0.11; 95% CI -0.20 to -0.01) were associated with worse cognition.

Conclusion

Adverse childhood exposures overall were not associated with worse cognition in older adults in a diverse sample, although three ACEs were associated with worse cognitive outcomes.

SUBMITTER: Gold AL

PROVIDER: S-EPMC7925876 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Are adverse childhood experiences associated with late-life cognitive performance across racial/ethnic groups: results from the Kaiser Healthy Aging and Diverse Life Experiences study baseline.

Gold Audra L AL Meza Erika E Ackley Sarah F SF Mungas Dan M DM Whitmer Rachel A RA Mayeda Elizabeth Rose ER Miles Sunita S Eng Chloe W CW Gilsanz Paola P Glymour M Maria MM

BMJ open 20210205 2

<h4>Objectives</h4>Evidence on adverse childhood experiences (ACEs) and late-life cognitive outcomes is inconsistent, with little research among diverse racial/ethnic groups. We investigated whether ACE exposures were associated with worse late-life cognition for all racial/ethnic groups and at different ages of exposure.<h4>Design</h4>Covariate-adjusted mixed-effects linear regression models estimated associations of: (1) total number of ACEs experienced, (2) earliest age when ACE occurred and ...[more]

PMID: 33550246

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Project description:BackgroundStudies have reported positive outcomes of blended care therapy (BCT), which combines face-to-face care with internet modules. However, there is insufficient evidence of its effectiveness across racial and ethnic groups. This study evaluated outcomes of a BCT program, which combined video psychotherapy with internet cognitive-behavioral modules, across race and ethnicity.MethodsParticipants were 6492 adults, with elevated anxiety (Generalized Anxiety Disorder-7 [GAD-7] ≥ 8) and/or depression (Patient Health Questionnaire-9 [PHQ-9] ≥ 10) symptoms, enrolled in employer-offered BCT. Changes in anxiety (GAD-7) and depression (PHQ-9) symptoms during treatment were evaluated using individual growth curve models. Interaction terms of time with race and ethnicity tested for between-group differences. Treatment satisfaction was assessed using a Net Promoter measure (range = 1 (lowest satisfaction) to 5 (greatest satisfaction)).ResultsParticipants' self-reported race and ethnicity included Asian or Pacific Islander (27.5%), Black or African American (5.4%), Hispanic or Latino (9.3%), and White (47.2%). Anxiety symptoms decreased during treatment (p < 0.01), with greater reductions among Hispanic or Latino participants compared to White participants (p < 0.05). Depressive symptoms decreased across treatment (p < 0.01), with significantly greater decreases among some racial and ethnic groups compared to White participants. Declines in anxiety and depressive symptoms slowed across treatment (p's < 0.01), with statistically significant differences in slowing rates of depressive symptoms across some racial and ethnic groups. Among participants with responses (28.45%), average treatment satisfaction ranged from 4.46 (SD = 0.73) to 4.67 (SD = 0.68) across race and ethnicity (p = 0.001). Racial and ethnic differences in outcomes were small in magnitude.ConclusionsBCT for anxiety and depression can be effective across diverse racial and ethnic groups.

Project description:Childhood adversity is a well-established risk factor for mental health problems during adolescence. Using data from the Fragile Families and Child Wellbeing Study and latent class analysis (LCA), we examined patterns of exposure to ten adverse childhood experiences (ACEs), including socioeconomic adversity, among non-Hispanic (NH) White, NH Black, and Hispanic 9 year olds and determined associations between membership in ACE exposure "classes" and depression and anxiety scores at age 15 (N = 2849). Parental separation/divorce, economic hardship, and paternal incarceration were the most common ACEs. ACE prevalence was significantly higher among Blacks and Hispanics. ACEs clustered into four classes for Whites and Hispanics and three classes for Blacks. Over half of Whites were classified in the 'Low Adversity' class. Conversely, most Black and Hispanic adolescents were classified in the 'High Socioeconomic Adversity and Paternal Incarceration' class, characterized by above average probabilities of experiencing family economic hardship, parental separation/divorce, low maternal education, and paternal incarceration. A small share of adolescents in all three racial/ethnic groups were in the 'High Global Adversity' class, characterized by high probability of exposure to most ACEs, including physical and psychological abuse. Finally, ACE class membership was differentially associated with anxiety and depression across the three racial/ethnic groups, with generally larger differences in mental health scores across ACE groups for Whites than for Blacks and Hispanics. Our findings suggest that studies on the associations between ACEs and health outcomes that do not include childhood economic adversity risk underestimating the role of ACEs on mental health among racial/ethnic minorities. Moreover, different patterns of ACE exposure are differentially linked to anxiety and depression, and ACE group membership differences in anxiety and depression vary by racial/ethnic group. Findings suggest the need for racially tailored prevention and intervention strategies.

Dataset Information

Are adverse childhood experiences associated with late-life cognitive performance across racial/ethnic groups: results from the Kaiser Healthy Aging and Diverse Life Experiences study baseline.

Objectives

Design

Setting

Participants

Results

Conclusion

Publications

Are adverse childhood experiences associated with late-life cognitive performance across racial/ethnic groups: results from the Kaiser Healthy Aging and Diverse Life Experiences study baseline.

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