Emotional neglect in childhood and cerebral infarction in older age

摘要

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.