Childhood Trauma Is Associated With Poorer Cognitive Performance in Older Adults

Abstract

Objective: Childhood trauma is common and associated with both worse cognitive performance and disruption to the hypothalamic-pituitary-adrenal axis in younger adults. The extent to which these associations persist into older adulthood remains unknown. The aim of this study was to investigate self-reported childhood trauma in relation to cognitive performance, and the extent to which cortisol explained this association, in 2 independent samples of older adults.

Methods: In this cross-sectional study, participants in the discovery sample (N = 76) consisted of older adults with a DSM-IV diagnosis of generalized anxiety disorder (N = 57) and age-equated psychiatrically healthy comparison subjects (N = 19) who were referred largely through primary care clinics between 2004-2006. The replication sample (N = 48) consisted of older adults with DSM-IV anxiety or depressive disorders recruited between 2012-2013. Participants were administered the Early Trauma Inventory Self-Report-Short Form and a neuropsychological assessment (primary outcome).

Results: Across both samples, childhood trauma was significantly associated with worse performance on measures of processing speed, attention, and executive functioning. The effect of trauma exposure was stronger when general, physical, and sexual traumatic events were examined specifically (all P < .05). Childhood trauma was not associated with cortisol levels, and cortisol did not explain the association between trauma and cognitive functioning.

Conclusions: Self-reported traumatic events experienced in childhood are associated with poorer cognitive performance in anxious and depressed older adults. Findings demonstrate a deleterious impact of childhood trauma on brain health in old age.

Figure 1.

Graph depicting the estimated performance, with 95% confidence interval, on cognitive tests and cortisol AUC by self-reported childhood trauma controlling for age, sex, education, health, GAD status, PTSD diagnosis, worry, and depressive symptoms. ^a Participants were divided into three categories: no traumatic events (ETISR-SF = 0), mean number of traumatic events (ETISR-SF = 4) or high levels of traumatic events (+1 SD, ETISR-SF=8).