The Role of Childhood Adversity and Social Drivers of Health in Subjective Cognitive Decline

Abstract

Introduction: Cognitive health is influenced by a complex interplay of factors throughout the lifespan. Identifying childhood adversities and social needs can be important in mitigating subjective cognitive decline and promoting healthy aging. This study analyzes the role of social drivers of health on adverse childhood experiences and subjective cognitive decline. Methods: We conducted structural equation modeling on data from the 2023 Behavioral Risk Factor Surveillance System to investigate the association among adverse childhood experiences, social drivers of health, and subjective cognitive decline in a sample of adults aged 45 years or older (n = 35,754).Results: In our study sample, 17.7% reported experiencing subjective cognitive decline within the past 12 months. Adverse childhood experiences were significantly associated with greater subjective cognitive decline (β = 0.136, P < .001). Adverse childhood experiences were negatively associated with both social drivers of health, perceived social support (β = -0.517, P < .001), and socioeconomic stability (β = -0.022, P = .047). However, greater perceived social support (β = -0.260, P < .001) and socioeconomic stability (β = -0.086, P < .001) reduced the effects of adverse childhood experiences on subjective cognitive decline. Conclusion: Adverse childhood experiences were significantly associated with subjective cognitive decline; however, this association was attenuated when mediated by perceived social support and socioeconomic stability. These findings can inform public health providers and policymakers to implement targeted interventions, such as promoting resilience, reinforcing nurturing parenting styles, strengthening community networks, and integrating behavioral health into primary care settings.