The Association Between Adverse Childhood Experiences and Patterns of Cognitive Decline: The Mediating Role of Allostatic Load

This study aimed to examine how adverse childhood experiences (ACEs) and allostatic load (AL) are associated with patterns of cognitive decline in older Chinese adults, and whether AL mediates the association between ACEs and cognitive decline. Using data from the China Health and Retirement Longitudinal Study (CHARLS, Waves 1–4), we applied latent class growth analysis to identify four distinct classes of cognitive decline trajectories and examined the mediating role of AL using the Karlson–Holm–Breen method. Results showed that increased ACEs were associated with a higher likelihood of membership in less favorable classes of cognitive decline, particularly among those with ≥2 deprivation-related ACEs. However, AL was not associated with the patterns of cognitive decline trajectories and did not mediate the relationship between ACEs and cognitive decline trajectories. These findings underscore the importance of providing children with available resources and support to mitigate ACEs and prevent adverse cognitive decline in later life.