Objectives: Early-life adversity is related to adult health in old age but little is known about its relation with cognitive decline. Methods: Participants includedmore than 6,100 older residents (mean age574.9 [7.1] years; 61.8% African American) enrolled in the Chicago Health and Aging Project, a geographically defined, population- based study of risk factors for Alzheimer disease. Participants were interviewed at approximately 3-year intervals for up to 16 years. The interview included a baseline evaluation of early-life adversity, and administration of 4 brief cognitive function tests to assess change in cognitive function. We estimated the relation of early-life adversity to rate of cognitive decline in a series of mixed-effectsmodels. Results: Inmodels stratified by race, and adjusted for age and sex, early-life adversitywas differentially related to decline in African Americans and whites. Whereas no measure of early-life adversity related to cognitive decline in whites, both food deprivation and being thinner than average in early life were associated with a slower rate of cognitive decline in African Americans. The relations were not mediated by years of education and persisted after adjustment for cardiovascular factors. Conclusions: Markers of early-life adversity had an unexpected protective effect on cognitive decline in African Americans.
Bibliographical noteFunding Information:
L. Barnes is funded by NIH grants AG022018 (principal investigator), AG10161 (coinvestigator), AG031553 (coinvestigator), and AG032247 (coinvestigator) . R. Wilson receives research support from NIH AG024871 (principal investigator), AG10161 (coinvestigator), AG11101 (coinvestigator), AG15819 (coinvestigator), AG026395 (coinvestigator), AG017917 (coinvestigator), AG009966 (coinvestigator), AG034374 (coinvestigator), AG39478 (coinvestigator), and AG036547 (coinvestigator) , and a grant from the Alzheimer's Association (NIRGD-11-205469 [coinvestigator]) . S. Everson-Rose is funded by AG040738 (principal investigator), HL091290 (principal investigator), HD068045 (coinvestigator), MD003422 (coinvestigator), and HL089862 (principal investigator of subcontract) . M. Hayward is funded by HD042849 (principal investigator) . D. Evans is funded (principal investigator or coinvestigator) by NIH grants AG11101, AG036650, AG09966, AG030146, AG10161, AG021972, ES10902, NR009543, HL084209, and AG12505l . C. Mendes de Leon is funded by NIH grants AG032247 (principal investigator), AG033172 (principal investigator of subcontract), and AG027708 (principal investigator) . Go to Neurology.org for full disclosures.