Association of own and spousal intra- and extra-familial adverse childhood experiences with cognitive function and the role of depression in middle-aged and older Chinese women

Objective To explore the associations of own and spousal intra- and extra-familial adverse childhood experiences (ACEs) with cognitive function and the role of depression in women. Methods Data were from the China Health and Retirement Longitudinal Study. ACEs included 11 intra-familial and 3 extra-familial domains. Principal component analysis was used to divide ACEs into mild, moderate, severe, and most severe. Depression was assessed using CESD-10 (cutoff≥10). Global cognition included episodic memory and mental intactness, with values ranging from 0 to 31. Adjusted multiple generalized linear regression models (GLM) were used to investigate the associations of own or spousal ACEs with women's cognitive function and the role of their depression in general women in Analysis 1 and married women in Analysis 2, respectively. Results Among 4613 women aged 59.0 (52.0–65.0) in Analysis 1, depression mediated 12.3%, 14.6%, and 9.5% the effects of most severe overall ACEs on global cognition, episodic memory, and mental intactness. In Analysis 2, most severe spousal overall ACEs were associated with women's mental intactness, with β (95% CI) of −0.120 (−0.217 to −0.023), which was mediated by women's depression by 19.8%. Furthermore, most severe spousal extra-familial ACEs were associated with women's global cognition, episodic memory, and mental intactness (β = −0.210, 95% CI -0.297 to −0.123; β = −0.150, 95% CI -0.241 to −0.060; β = −0.211, 95% CI -0.302 to −0.121), which was 7.6%, 9.4%, and 6.0% mediated by their depression. Conclusion Depression mediated the effects of own and spousal extra-familial (not intra-familial) ACEs on women's cognitive function.