The Association Between Childhood Adversity and Cognitive Aging Trajectory in Later Life: Evidence from the China Health and Retirement Longitudinal Study (CHARLS)

OBJECTIVES: This study examined the association between childhood adversity and cognitive aging trajectories among Chinese older adults, exploring the mediating role of depressive symptoms. METHODS: Using five waves of the China Health and Retirement Longitudinal Study (CHARLS 2011-2020), we applied the group-based trajectory model, multinomial logistic regression and mediation analysis. RESULTS: Cognitive aging trajectories in older Chinese adults were classified into three patterns: high baseline with slow decline (HBSD), medium baseline with moderate decline (MBMD), and low baseline with rapid decline (LBRD). Childhood adversity increased the likelihood of being in the LBRD (OR: 1.21, 95% CI: 1.15-1.27) and MBMD (OR: 1.11, 95% CI: 1.06-1.15) compared with HBSD, and in the LBRD relative to MBMD (OR: 1.09, 95% CI: 1.05-1.15). Depressive symptoms significantly mediated the associations between childhood adversity and cognitive aging trajectories. CONCLUSIONS: Childhood adversity has a direct effect and an indirect effect on cognitive aging trajectories through the depressive symptoms. Addressing depressive symptoms may help mitigate the long-term negative impact of early-life adversity on cognitive aging in older adults. CLINICAL IMPLICATIONS: Targeting depressive symptoms may be a key intervention point for promoting healthy cognitive aging in older adults who experienced childhood adversity.