Heterogeneous adverse childhood experiences and cognitive function in an elderly Chinese population: a cohort study.

OBJECTIVE: To identify the heterogeneity of adverse childhood experiences (ACEs) as well as their association with cognitive function in an elderly Chinese population. DESIGN: A retrospective cohort study. PARTICIPANTS: The data were from the latest wave of the China Health and Retirement Longitudinal Study and a total of 7222 participants aged ≥60 were included. PRIMARY AND SECONDARY OUTCOME MEASURES: Latent class analysis was used to identify the classes characterised by 11 types of ACEs. Cognitive function was measured by the Mini-Mental State Examination (MMSE) and cognitive impairment was defined by education-specific threshold MMSE scores. Logistic models were constructed to examine the relationship between ACE classes and cognitive impairment. Several childhood and adulthood confounding factors were considered. RESULTS: Three ACE latent classes were identified. Of them, 76.09% were in the 'Low ACEs' class, 15.43% were in the 'Household dysfunction' class and 8.49% were in the 'Child maltreatment' class. The people in the 'Low ACEs' class seemed to have better childhood family financial situations and higher education levels. The population in the 'Household dysfunction' class tended to live in rural areas and have a higher proportion of men, whereas people in the 'Child maltreatment' class showed a significantly higher proportion of women and higher levels of chronic diseases. 'Child maltreatment' was related to a higher risk of cognitive impairment (OR=1.37, 95% CI: 1.12 to 1.68), while the risk of 'Household dysfunction' was not significantly different from that of the 'Low ACEs' participants (OR=1.06, 95% CI: 0.90 to 1.26). CONCLUSIONS: The findings supported differences in cognitive function in elderly Chinese people exposed to different types of ACEs.

Gender-specific effects of adverse childhood experiences on incidence of activities of daily life disability in middle-age and elderly Chinese population.

BACKGROUND: Adverse Childhood Experiences (ACEs) may have long-lasting effects on late life health, probably through life-course mediators. However, whether such effects still exist when these mediators have been appropriately controlled is unclear. OBJECTIVES: To estimate the controlled direct effect of ACEs on Activities of Daily Life (ADL) disability in middle-aged people and examine the gender-difference of this effect. PARTICIPANTS AND SETTING: We used data from the China Health and Retirement Longitudinal Study, a nationally representative longitudinal survey of persons aged 45+ years. METHODS: ACEs were measured by the Adverse Childhood Experiences International Questionnaire and number of ACEs was classified as 0, 1, 2 and 3+, while ADL disability was measured using the Katz Index. Gender-specific controlled direct effects of ACEs on the incidence of ADL disability were estimated by marginal structural model (MSM) with stabilized inverse-probability-of-treatment weights of mediators (unhealthy behaviors, chronic diseases and depression). RESULTS: 4,544 males and 4,767 females were included. Gender differences existed in most categories of ACEs, and about 10 % participants had 3+ ACEs. Participants who had 3+ ACEs had 39 % and 59 % higher risk of ADL disability than those with 0 ACEs among males and females, respectively. After controlling for the mediators, the direct effect was slightly increased in males (risk ratio (RR) = 1.45, p < 0.001) but decreased in females (RR=1.28, p < 0.05). CONCLUSIONS: Precautions targeted in reducing ACEs may be beneficial in preventing ADL disability, but gender-specific prevention should be considered.

Apocynin inhibits placental TLR4/NF-κB signaling pathway and ameliorates preeclampsia-like symptoms in rats.

OBJECTIVE: We aimed to investigate the potency of apocynin in ameliorating preeclampsia and explore the underlying mechanisms. METHODS: Preeclampsia model was constructed in rats by administering 200 mg/kg/day L-NAME. Apocynin was given orally in drinking water. Systolic blood pressure and proteinuria were monitored during treatment. Survival rate rate of the pups and placental weight were assessed. Serum sFlt-1, PIGF, IL-6 and placental TLR4 levels were measured using ELISA or qRT-PCR. RESULTS: Apocynin dose-dependently decreased systolic blood pressure and proteinuria during gestation. Survival rate of the pups and placental weight were improved by apocynin treatment. Apocynin ameliorated the imbalance of sFlt-1 and PIGF in serum and placenta of rats with preeclampsia. Apocynin attenuated serum inflammatory cytokine expression and placental inflammation most likely due to downregulation of the placental TLR4/NF-kB pathway in L-NAME treated rats. CONCLUSIONS: Apocynin potently ameliorates the L-NAME-induced preeclampsia, which is achieved by re-balancing the sFlt-1 and PIGF levels, attenuating inflammation, and inhibiting TLR4/NF-κB p65 signaling.