Stress sensitization: Does childhood adversity modify trauma effects on memory?

BackgroundTrauma across the lifecourse is implicated in adverse health outcomes, yet whether earlier adversity shapes vulnerability to effects of later trauma on cognitive decline, an important contributor to Alzheimer's disease, remains unclear.ObjectiveWe examined the impact of adult incident traumatic experiences (ITEs) on late-life memory decline, and whether this association is modified by childhood adversity.MethodsWe leveraged 2006-2020 data from the Health and Retirement Study, a longitudinal cohort of US adults aged ≥50 years. ITEs were self-reported stressful or life-threatening experiences in 2006-2012 (any versus none). Childhood adversity (any versus none) included retrospective reports of abuse, neglect, or household dysfunction before age 18. Memory was assessed biennially from 2010-2020 using standardized scores. Linear mixed-effects models estimated associations between ITEs and decline in memory z-score, adjusted for demographics, childhood socioeconomic status, and self-rated health. Stratified analyses examined effect modification by childhood adversity.ResultsAmong 2971 participants, mean baseline age was 67.3 years (SD 9.2); 60% were female and 86% were White. Individuals with ITEs experienced a faster memory decline than those without ITEs (β= -0.014 SD units/year, 95% CI -0.024, -0.003). Childhood adversity did not modify this association. Findings were consistent across sensitivity analyses using alternative exposure and outcome definitions.ConclusionsITEs were associated with accelerated memory decline in later life, and childhood adversity did not modify this relationship. Identifying resilience factors that mitigate the cognitive effects of adult traumatic experiences may inform prevention strategies for Alzheimer's disease.