B – 3 Adverse Childhood Experiences and Late-Life Microinfarcts: An Observational Study

Abstract Objective Alzheimer’s disease (AD) is the leading cause of dementia, and cerebrovascular pathology—including chronic microinfarcts—is a co-occurring factor that may contribute to AD risk. Adverse childhood experiences (ACEs), defined as early-life exposure to abuse, neglect, or household dysfunction, are linked to long-term cerebrovascular disease (CVD) risk and may increase vulnerability to vascular brain injury in later life. While early adversity is associated with CVD, its relationship with microinfarcts remains unclear. Clarifying this association could inform mechanisms underlying AD. We hypothesized that higher ACE scores would predict greater likelihood of chronic microinfarcts in late life. Method Data from 862 community-dwelling older adults in the Rush Alzheimer’s Disease Center cohorts were analyzed. ACEs were measured continuously via self-report, with higher scores reflecting greater exposure to traumatic events from birth to age 18. Microinfarcts were identified through self-report and medical record review, and coded dichotomously (0 = none, 1 = ≥1). Binary logistic regression examined whether ACE scores (predictor) were associated with microinfarcts (outcome), adjusting for sex and education. Interaction terms between ACEs, sex, and education were also tested. Results ACE scores were not significantly associated with chronic microinfarcts (OR = 1.01, 95% CI [0.99, 1.03], p = .33). Sex, education, and interaction terms were also non-significant (p’s > .05), and the model explained < 1% of the variance (McFadden’s R2 = .003). Conclusion Despite theoretical links between early adversity and cerebrovascular injury, ACEs were not associated with microinfarcts in this sample. Further research is needed to clarify the vascular pathways through which early-life stress may impact brain aging.