Adverse childhood experiences, cognitive outcomes, and frailty in older adults: a systematic review and meta-analysis.
Fengxue Yang, Hongli Miao, Bing Cao et al.
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In 30 seconds
This systematic review and meta-analysis examined associations between adverse childhood experiences (ACEs) and frailty or cognitive outcomes in middle-aged and older adults. It included 26 observational studies; 5 contributed to the frailty meta-analysis and 6 to cognitive-outcome analyses. ACEs were associated with higher odds of frailty (OR = 2.05, 95% CI 1.61-2.63), objective cognitive impairment (OR = 1.46, 95% CI 1.18-1.82), and subjective cognitive decline (OR = 2.04, 95% CI 1.40-2.98). Measures of ACEs, frailty, and cognition varied substantially across studies.
Key findings
- ACEs were associated with higher odds of frailty (OR = 2.05, 95% CI 1.61-2.63).
- ACEs were associated with higher odds of objective cognitive impairment (OR = 1.46, 95% CI 1.18-1.82).
- ACEs were associated with higher odds of subjective cognitive decline (OR = 2.04, 95% CI 1.40-2.98).
- The review included 26 observational studies, with 5 and 6 studies contributing to the frailty and cognitive meta-analyses, respectively.
Why it matters
The findings connect childhood adversity with later-life vulnerability across both physical frailty and cognitive outcomes, supporting a life-course perspective in aging research. For clinicians and researchers, this association highlights the potential relevance of early-life experiences when considering later-life risk, while the observational evidence does not establish that ACEs cause these outcomes.
What to keep in mind
All included studies were observational, and measures of ACEs, frailty, and cognitive outcomes varied substantially across studies.