{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:22:17Z","timestamp":1787764937092,"version":"build-2784847793"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Institute on Aging of the National Institutes of Health","award":["R01AG067625"],"award-info":[{"award-number":["R01AG067625"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Dementia prevalence is rising dramatically in China. Adverse Childhood Experiences (ACEs) are linked to cognitive function in later life, but the specific pathways underlying this connection are not well understood. Drawing on the chain-of-risk model and the Dimensional Model of Adversity and Psychopathology, this study tested whether 11 individual ACEs are associated with later-life cognition directly or indirectly through 13 modifiable dementia risk factors identified by the Lancet Commission, and whether threat, deprivation, and household-disruption ACEs operate through theoretically distinct pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>We utilized data from 20,010 adults aged 40\u2009years or more from the China Health and Retirement Longitudinal Study and its 2014 Life History Survey. Structural equation modeling was employed to simultaneously test the direct paths from individual ACEs to a latent global cognition factor and the indirect paths through dementia risk factors (e.g., less education, depression), controlling for covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Emotional abuse and community violence showed significant direct negative associations with later-life cognition that persisted after mediators were included. Physical neglect and parental divorce or death showed significant indirect negative effects, operating through less education, depression, and untreated vision loss. Emotional neglect and household violence showed unexpected positive direct associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Implications<\/jats:title>\n                    <jats:p>ACEs reach later-life cognition through qualitatively distinct routes. Effective intervention requires both upstream social-determinants policies and clinical attention to ACE history as a marker of cognitive risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/geront\/gnag147","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T16:43:29Z","timestamp":1782751409000},"source":"Crossref","is-referenced-by-count":0,"title":["Pathways from adverse childhood experiences to later-life cognition in China"],"prefix":"10.1093","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7543-7096","authenticated-orcid":false,"given":"Dayoung","family":"Lee","sequence":"first","affiliation":[{"name":"Center for Economic and Social Research, University of Southern California , Los Angeles, California,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3469-1549","authenticated-orcid":false,"given":"Seo-Yun","family":"Choi","sequence":"additional","affiliation":[{"name":"Suzanne Dworak-Peck School of Social Work, University of Southern California , Los Angeles, California,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"2026082612515465400_gnag147-B1","author":"2014 CHARLS Life History Survey Release Note","year":"2016"},{"key":"2026082612515465400_gnag147-B2","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1007\/s00127-024-02676-4","article-title":"Adverse childhood experiences and risk of late-life dementia: a systematic review and meta-analysis","volume":"60","author":"Abouelmagd","year":"2024","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"key":"2026082612515465400_gnag147-B3","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1037\/0033-2909.110.1.26","article-title":"Parental divorce and the well-being of children: A meta-analysis","volume":"110","author":"Amato","year":"1991","journal-title":"Psychological Bulletin"},{"key":"2026082612515465400_gnag147-B4","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/S0749-3797(18)30622-6","article-title":"Screening for depression in well older adults: Evaluation of a short form of the CES-D","volume":"10","author":"Andresen","year":"1994","journal-title":"American Journal of Preventive Medicine"},{"key":"2026082612515465400_gnag147-B5","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1001\/jamapsychiatry.2019.0097","article-title":"Agreement between prospective and retrospective measures of childhood maltreatment: A systematic review and meta-analysis","volume":"76","author":"Baldwin","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"2026082612515465400_gnag147-B6","doi-asserted-by":"publisher","first-page":"100","DOI":"10.3389\/fpsyg.2019.00100","article-title":"The history and the future of the psychology of filial piety: Chinese norms to contextualized personality construct","volume":"10","author":"Bedford","year":"2019","journal-title":"Frontiers in Psychology"},{"key":"2026082612515465400_gnag147-B7","doi-asserted-by":"publisher","first-page":"e517","DOI":"10.1016\/S2468-2667(19)30145-8","article-title":"Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: A systematic review and meta-analysis","volume":"4","author":"Bellis","year":"2019","journal-title":"The Lancet. Public Health"},{"key":"2026082612515465400_gnag147-B8","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1037\/0033-2909.107.2.238","article-title":"Comparative fit indexes in structural models","volume":"107","author":"Bentler","year":"1990","journal-title":"Psychological Bulletin"},{"key":"2026082612515465400_gnag147-B9","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1002\/(SICI)1099-1166(199908)14:8%3C608::AID-GPS991%3E3.0.CO;2-Z","article-title":"Cross-validation of a short form of the CES-D in Chinese elderly","volume":"14","author":"Boey","year":"1999","journal-title":"International Journal of Geriatric Psychiatry"},{"key":"2026082612515465400_gnag147-B10","volume-title":"Handbook of Regression Analysis.","author":"Chatterjee","year":"2013"},{"key":"2026082612515465400_gnag147-B11","doi-asserted-by":"publisher","first-page":"101106","DOI":"10.1016\/j.lanwpc.2024.101106","article-title":"Temporal trends and disparities of population attributable fractions of modifiable risk factors for dementia in China: A time-series study of the China Health and Retirement Longitudinal Study (2011\u20132018)","volume":"47","author":"Chen","year":"2024","journal-title":"The Lancet Regional Health - Western Pacific"},{"key":"2026082612515465400_gnag147-B12","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/j.jalz.2009.02.007","article-title":"Telephone interview for cognitive status: Creating a crosswalk with the Mini-Mental State Examination","volume":"5","author":"Fong","year":"2009","journal-title":"Alzheimer\u2019s & Dementia: The Journal of the Alzheimer\u2019s Association"},{"key":"2026082612515465400_gnag147-B13","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1176\/appi.ajp.160.5.939","article-title":"Family disruption in childhood and risk of adult depression","volume":"160","author":"Gilman","year":"2003","journal-title":"The American Journal of Psychiatry"},{"key":"2026082612515465400_gnag147-B14","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1186\/s12877-023-04205-5","article-title":"New evidence of trends in cognitive function among middle-aged and older adults in China, 2011\u20132018: An age-period-cohort analysis","volume":"23","author":"Guo","year":"2023","journal-title":"BMC Geriatrics"},{"key":"2026082612515465400_gnag147-B15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives","volume":"6","author":"Hu","year":"1999","journal-title":"Structural Equation Modeling: A Multidisciplinary Journal"},{"key":"2026082612515465400_gnag147-B16","doi-asserted-by":"publisher","first-page":"e661","DOI":"10.1016\/S2468-2667(20)30185-7","article-title":"Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: A cross-sectional study","volume":"5","author":"Jia","year":"2020","journal-title":"The Lancet Public Health"},{"key":"2026082612515465400_gnag147-B17","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1177\/0891988714522696","article-title":"Adverse childhood and recent negative life events: Contrasting associations with cognitive decline in older persons","volume":"27","author":"Korten","year":"2014","journal-title":"Journal of Geriatric Psychiatry and Neurology"},{"key":"2026082612515465400_gnag147-B18","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1136\/jech.57.10.778","article-title":"Life course epidemiology","volume":"57","author":"Kuh","year":"2003","journal-title":"Journal of Epidemiology and Community Health"},{"key":"2026082612515465400_gnag147-B19","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.jeoa.2013.11.001","article-title":"Gender differences in cognition in China and reasons for change over time: Evidence from CHARLS","volume":"4","author":"Lei","year":"2014","journal-title":"The Journal of the Economics of Ageing"},{"key":"2026082612515465400_gnag147-B20","doi-asserted-by":"publisher","first-page":"e2241714","DOI":"10.1001\/jamanetworkopen.2022.41714","article-title":"Association of adverse childhood experiences and social isolation with later-life cognitive function among adults in China","volume":"5","author":"Lin","year":"2022","journal-title":"JAMA Network Open"},{"key":"2026082612515465400_gnag147-B21","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","article-title":"Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission","volume":"404","author":"Livingston","year":"2024","journal-title":"Lancet (London, England)"},{"key":"2026082612515465400_gnag147-B22","doi-asserted-by":"publisher","first-page":"e0256297","DOI":"10.1371\/journal.pone.0256297","article-title":"The influence of childhood adversities on mid to late cognitive function: From the perspective of life course","volume":"16","author":"Ma","year":"2021","journal-title":"PLoS One"},{"key":"2026082612515465400_gnag147-B23","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1016\/j.neubiorev.2014.10.012","article-title":"Childhood adversity and neural development: Deprivation and threat as distinct dimensions of early experience","volume":"47","author":"McLaughlin","year":"2014","journal-title":"Neuroscience and Biobehavioral Reviews"},{"key":"2026082612515465400_gnag147-B24","author":"Muth\u00e9n","year":"1997"},{"key":"2026082612515465400_gnag147-B25","doi-asserted-by":"publisher","first-page":"525","DOI":"10.3102\/00346543074004525","article-title":"Missing data in educational research: A review of reporting practices and suggestions for improvement","volume":"74","author":"Peugh","year":"2004","journal-title":"Review of Educational Research"},{"key":"2026082612515465400_gnag147-B26","volume-title":"Harmonized CHARLS Documentation","author":"Phillips","year":"2021"},{"key":"2026082612515465400_gnag147-B27","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.glt.2022.12.001","article-title":"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","volume":"4","author":"Ren","year":"2022","journal-title":"Global Transitions"},{"key":"2026082612515465400_gnag147-B28","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1037\/0033-2909.128.2.330","article-title":"Risky families: Family social environments and the mental and physical health of offspring","volume":"128","author":"Repetti","year":"2002","journal-title":"Psychological Bulletin"},{"key":"2026082612515465400_gnag147-B29","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1002\/gps.2553","article-title":"Adverse childhood environment and late-life cognitive functioning","volume":"26","author":"Ritchie","year":"2011","journal-title":"International Journal of Geriatric Psychiatry"},{"key":"2026082612515465400_gnag147-B30","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v048.i02","article-title":"lavaan: An R package for structural equation modeling","volume":"48","author":"Rosseel","year":"2012","journal-title":"Journal of Statistical Software"},{"key":"2026082612515465400_gnag147-B31","author":"Steiger","year":"1980"},{"key":"2026082612515465400_gnag147-B32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/BF02291170","article-title":"A reliability coefficient for maximum likelihood factor analysis","volume":"38","author":"Tucker","year":"1973","journal-title":"Psychometrika"},{"key":"2026082612515465400_gnag147-B33","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1136\/jech-2019-212738","article-title":"Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): A systematic review","volume":"73","author":"Walsh","year":"2019","journal-title":"Journal of Epidemiology and Community Health"},{"key":"2026082612515465400_gnag147-B6835025","doi-asserted-by":"publisher","first-page":"1529969","DOI":"10.3389\/fpubh.2025.1529969","article-title":"Associations of modifiable dementia risk factors with dementia and cognitive decline: evidence from three prospective cohorts","volume":"13","author":"Wang","year":"2025","journal-title":"Frontiers in Public Health"},{"key":"2026082612515465400_gnag147-B34","doi-asserted-by":"publisher","first-page":"636","DOI":"10.2174\/0115672050281539231222071355","article-title":"Childhood maltreatment and dementia risk factors in midlife: A prospective investigation","volume":"20","author":"Widom","year":"2023","journal-title":"Current Alzheimer Research"},{"key":"2026082612515465400_gnag147-B35","author":"World Health Organization","year":"2011"},{"key":"2026082612515465400_gnag147-B36","author":"World Health Organization","year":"2018"},{"key":"2026082612515465400_gnag147-B37","doi-asserted-by":"publisher","first-page":"935254","DOI":"10.3389\/fpsyg.2022.935254","article-title":"Childhood adversity and cognitive impairment in later life","volume":"13","author":"Xiang","year":"2022","journal-title":"Frontiers in Psychology"},{"key":"2026082612515465400_gnag147-B38","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1093\/ije\/dyx222","article-title":"Early life exposure to China\u2019s 1959\u201361 famine and midlife cognition","volume":"47","author":"Xu","year":"2018","journal-title":"International Journal of Epidemiology"},{"key":"2026082612515465400_gnag147-B39","doi-asserted-by":"publisher","first-page":"105079","DOI":"10.1016\/j.chiabu.2021.105079","article-title":"Gender-specific effects of adverse childhood experiences on incidence of activities of daily life disability in middle-age and elderly Chinese population","volume":"117","author":"Yuan","year":"2021","journal-title":"Child Abuse & Neglect"},{"key":"2026082612515465400_gnag147-B40","doi-asserted-by":"publisher","first-page":"2847","DOI":"10.3390\/ijerph16162847","article-title":"Changes in cognitive function and risk factors for cognitive impairment of the elderly in China: 2005\u20132014","volume":"16","author":"Zhang","year":"2019","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"2026082612515465400_gnag147-B41","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1016\/j.jad.2022.12.058","article-title":"Adverse childhood experiences and their impacts on subsequent depression and cognitive impairment in Chinese adults: A nationwide multi-center study","volume":"323","author":"Zhang","year":"2023","journal-title":"Journal of Affective Disorders"},{"key":"2026082612515465400_gnag147-B42","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort profile: The China Health and Retirement Longitudinal Study (CHARLS)","volume":"43","author":"Zhao","year":"2014","journal-title":"International Journal of Epidemiology"}],"container-title":["The Gerontologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/gerontologist\/advance-article-pdf\/doi\/10.1093\/geront\/gnag147\/68645725\/gnag147.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gerontologist\/article-pdf\/66\/9\/gnag147\/68645725\/gnag147.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gerontologist\/article-pdf\/66\/9\/gnag147\/68645725\/gnag147.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:51:59Z","timestamp":1787763119000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/gerontologist\/article\/doi\/10.1093\/geront\/gnag147\/8721572"}},"subtitle":[],"editor":[{"given":"Joseph E","family":"Gaugler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":43,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,8,5]]}},"URL":"https:\/\/doi.org\/10.1093\/geront\/gnag147","relation":{},"ISSN":["0016-9013","1758-5341"],"issn-type":[{"value":"0016-9013","type":"print"},{"value":"1758-5341","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,6,29]]},"article-number":"gnag147"}}