Childhood adversity linked to poorer cognitive function across different patterns of aging

A new study published in the International Journal of Geriatric Psychiatry suggests that difficult experiences in childhood can negatively impact brain health decades later in older adults. The findings indicate that these early adversities leave a lasting mark on cognitive function, persisting regardless of an individual’s physical or mental health changes as they age. This research provides evidence that interventions to protect brain health may need to account for personal history extending back to the earliest years of life.

Societies around the world are facing demographic shifts toward older populations, which has led to a rise in age-related chronic conditions. Cognitive decline is a significant concern within this context because it often precedes dementia and results in a loss of independence. Previous scientific inquiries have typically examined physical health, mental well-being, and cognitive function as separate domains. In reality, these aspects of health often change together and influence one another over time.

Medical professionals refer to the simultaneous presence of multiple health conditions as multimorbidity. The interplay between physical and mental health is well-documented, with deterioration in one area often accelerating decline in the other. However, less is known about how these combined health trajectories interact with early life experiences.

“We were primarily motivated by several reasons,” Shanquan (Shaun) Chen, an assistant professor at the University of Hong Kong. “First, although cognitive decline, physical deterioration, and depressive symptoms often unfold together in older adults, very few studies have examined how these domains change simultaneously over time. This leaves an important gap in understanding the multidimensional nature of aging.”

“Second, while childhood adversity has been consistently linked to poorer physical and mental health in adulthood, its long-term consequences for later-life cognitive function remain debated. In particular, it is unclear whether the impact of early adversity differs depending on the type of aging trajectory an individual follows, such as rapid decline versus stability or improvement. This uncertainty represents both a conceptual and empirical gap.”

The research team utilized data from the China Health and Retirement Longitudinal Study. This is a nationally representative survey that tracks the health and social status of individuals in China over time. The final analysis included 6,178 adults aged 60 and older. The researchers looked at data spanning a ten-year period from 2011 to 2020. This longitudinal design allowed them to track changes in health status rather than relying on a single measurement.

To assess cognitive function, the study employed tests of episodic memory and attention. Episodic memory was measured by asking participants to recall a list of ten words immediately after hearing them and again after a delay. Attention was evaluated using a “serial seven subtraction” task, where participants were asked to subtract seven from 100 consecutively up to five times. These scores were combined to create a total cognitive function score ranging from 0 to 25.

Physical health was measured by checking if participants had difficulty with daily tasks. The researchers assessed “Basic Activities of Daily Living,” which included tasks such as dressing, bathing, eating, and getting in and out of bed. They also assessed “Instrumental Activities of Daily Living,” which covered more complex tasks like managing money, taking medications, shopping for groceries, and making phone calls. Higher scores on these measures indicated greater physical limitations.

Mental health was evaluated using a standard ten-item scale designed to measure depressive symptoms. Participants reported how often they experienced feelings such as fear, loneliness, or exhaustion during the past week. To measure early-life stress, the study asked participants about 13 specific adverse experiences occurring before age 17. These included events such as parental death, parental mental illness, neglect, physical abuse, domestic violence, or family substance abuse.

The researchers used a statistical technique called Latent Class Growth Modeling to identify patterns in the data. This method allows statisticians to group individuals into distinct “classes” based on how their health scores changed over the decade. The goal was to find subgroups of people who followed similar aging paths.

The analysis revealed four distinct groups of aging trajectories. The largest group, comprising nearly 60 percent of the sample, was classified as “healthy individuals.” This group maintained generally stable and healthy levels across cognitive, physical, and mental domains.

A second group, representing about 16.5 percent of the participants, was characterized by “rapid cognitive decline with gradual physical-mental decline.” These individuals experienced a sharp drop in brain function alongside a slow deterioration in their physical and mental health.

A third group, making up 14.4 percent of the sample, showed “mild cognitive decline with physical-mental improvement.” This group displayed a slight drop in cognitive scores but, notably, saw improvements in their physical and mental health metrics over the decade.

“The group whose physical and mental health improved still experienced cognitive decline,” Chen told PsyPost. “This suggests that cognitive aging can deteriorate even when other health domains improve, highlighting partially independent pathways.”

The final group, accounting for 9.4 percent, was labeled “moderate cognitive decline with rapid physical and moderate mental decline.” This group experienced deterioration across all three health domains, with physical health worsening most rapidly.

The researchers found a consistent negative association between childhood adversity and later-life cognitive scores. Individuals who reported experiencing three or more adverse childhood events had lower cognitive function compared to those with no such history. This pattern remained evident even after the researchers statistically accounted for adult education, income, marital status, and lifestyle behaviors like smoking or exercise.

The negative link between early trauma and cognitive performance existed across the different health trajectories. This consistency suggests that the impact of early adversity acts like a “scar,” affecting the brain regardless of how healthy a person is in other aspects of their adult life.

“The impact of childhood adversity was consistent across all trajectory groups,” Chen explained. “We expected the effects to differ based on aging patterns, but the ‘early-life imprint’ appeared similarly strong regardless of later-life health trajectory.”

“The key message is simple: Experiences in childhood can shape brain health many decades later, even after accounting for adult lifestyle, socioeconomic status, and chronic conditions. Although older adults follow very different patterns of physical, mental, and cognitive aging, the impact of childhood adversity on later-life cognition was remarkably consistent.”

As with all research, there are some limitations. The study relied on participants recalling events from decades earlier, which introduces the possibility of memory bias. The measure of mental health focused primarily on depressive symptoms, potentially missing other aspects of psychological well-being like anxiety.

Because this was an observational study, it can identify associations but cannot definitively prove that childhood adversity causes cognitive decline. “Although the longitudinal design strengthens inference, unmeasured factors (e.g., genetics, environmental exposures) may contribute,” Chen said.

He also emphasized that “childhood adversity does not determine your destiny. It increases risk, but many individuals still maintain good cognitive health.”

Future research should aim to identify the biological mechanisms that connect early stress to the aging brain. Potential pathways include chronic inflammation or long-term changes in the body’s stress response systems.

The researchers also suggest examining specific types of adversity rather than just the total number of events to see if certain experiences are more damaging than others. Validating these health trajectory patterns in different cultural populations would help generalize the findings. Finally, developing intervention strategies that span the entire life course could help mitigate these long-term risks.

“One of the most important insights is that aging is not uniform,” Chen explained. “Older adults follow diverse health trajectories, and these trajectories interact with early-life experiences in nuanced ways. Understanding these patterns can help policymakers and clinicians move beyond ‘one-size-fits-all’ models toward precision aging—tailored prevention and support strategies that meet individuals where they are in their life-course pathways.”

The study, “Childhood Adversity and Cognitive Function Across Physical‐Mental‐Cognitive Health Trajectories: A 10‐Year Longitudinal Study of Chinese Older Adults,” was authored by Yin Wang, Jiazhou Yu, Yiqiong Yang, and Shanquan Chen.