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Abstract
Objective: The purpose of the study was to test the hypothesis that a higher level of childhood adversity is associated with increased risk of cerebral infarction in old age.
Methods: Older participants in a longitudinal clinical–pathologic study rated adverse childhood experiences (e.g., emotional neglect, parental intimidation and violence) on a previously established 16-item scale. During a mean of 3.5 years of follow-up, there were 257 deaths, with 206 brain autopsies (80.2). Number of chronic cerebral infarcts (gross plus microscopic; expressed as 0, 1, or >1) was determined in a uniform neuropathologic examination, which had been completed in 192 individuals at the time of these analyses.
Results: Childhood adversity scores ranged from 0 to 31 (mean = 8.3, SD = 6.4). In an ordinal logistic regression model adjusted for age, sex, and education, higher adversity was associated with higher likelihood of chronic cerebral infarction. In analyses of childhood adversity subscales, only emotional neglect was associated with infarction (odds ratio [OR] = 1.097; 95% confidence interval [CI] 1.048–1.148). The likelihood of infarction was 2.8 times higher (95% CI 2.0–4.1) in those reporting a moderately high level of childhood emotional neglect (score = 6, 75th percentile) vs a moderately low level of neglect (score = 1, 25th percentile). Results were comparable in subsequent analyses that controlled for lifetime socioeconomic status, cardiovascular risk factors, and an anxiety-related trait.
Conclusion: Emotional neglect in childhood may be a risk factor for cerebral infarction in old age.
Glossary
- GLOSSARY
- CI =
- confidence interval;
- OR =
- odds ratio
Footnotes
Study funding: Supported by the National Institutes of Health (R01AG17917, R01AG24480, R01AG24871, R01HL94966, R01AG33678, and R01AG34374) and the Illinois Department of Public Health. The funding organizations had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.
Editorial, page 1524.
Supplemental data at www.neurology.org
- Received December 14, 2011.
- Accepted April 10, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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