Impact of Childhood Adversity on Late-Life Cognition in Older Puerto Rican Adults

Abstract Objectives This study examined the association between childhood adversity and late-life cognitive outcomes among older Puerto Rican adults. Methods Data were from the PREHCO study, a population-based cohort of 3,713 older Puerto Rican adults (mean age 72.5 years; 60% female). Adverse childhood experiences (ACEs) were categorised into four factors: economic hardship, parental illiteracy, childhood illness, and neighbourhood disadvantage. Cognition was assessed with the Mini-Mental Cabán (MMC). For our analyses, cognitive impairment was defined as scoring 1.5 SD below expected score, adjusted for age, sex, education, and reading ability. Ordinal logistic regression (baseline) and generalised linear mixed models (all three waves) analysed MMC scores; generalised estimating equations assessed incident cognitive impairment (waves 2 and 3). Results All four adversity factors were associated with poorer MMC scores at baseline. Parental illiteracy (β=-0.35, p<.001) and neighbourhood disadvantage (β=-0.27, p<.001) showed stronger associations than economic hardship (β=-0.10, p=.003) and childhood illness (β=-0.21, p<.001). No factors were significantly related to changes in cognitive scores over time. Depressive symptoms and self-rated health partially mediated cross-sectional relationships, with depressive symptoms showing a stronger effect. All adversity factors except economic hardship were linked to baseline cognitive impairment (OR=1.42 parent illiteracy, OR=1.24 childhood illness, OR=1.82 neighbourhood disadvantage, p<.05). Only neighbourhood disadvantage was associated with incident cognitive impairment (OR=1.19, p=.003). Discussion This study highlights the lasting impact of childhood adversity on late-life cognitive health among older Puerto Ricans, suggesting that addressing early adversity may promote cognitive health later in life.