Influence of Adverse Childhood Experiences on Trajectories of Cognitive Function: A Nationwide Longitudinal Study of Middle-Aged and Older Adults in China From 2011 to 2018

Purpose: Adverse childhood experiences (ACEs) have been confirmed to be associated with cognitive function, but their influence on the trajectories of cognitive function among middle-aged and older adults in China is not well understood. The current study sought to identify distinct trajectories of cognitive function and examine the influence of ACEs on these trajectories. Method: Data from 3,024 participants aged ≥45 years from four waves of the China Health and Retirement Longitudinal Study (CHARLS 2011–2018) were analyzed. Cognitive function was assessed using episodic memory and mental intactness measures, with ACEs retrospectively reported in the 2014 life history survey. Latent growth mixture modeling (LGMM) identified distinct cognitive trajectories, and multinomial logistic regression examined the association between ACEs and cognitive trajectory. Results: LGMM revealed three cognitive trajectories: Class 1 (stable increasing type with low starting point), Class 2 (descending type with high starting point), and Class 3 (descending type at the middle level). Higher ACEs scores were associated with increased likelihood of belonging to the less favorable cognitive function trajectories. Conclusion: Findings suggest that ACEs are significantly associated with cognitive function among middle-aged and older adults in China, with higher ACEs scores being more likely to be associated with less favorable cognitive function trajectories.