Linking Adverse Childhood Experiences and Other Risk Factors to Subjective Cognitive Decline in an Aging Population

Introduction The Centers for Disease Control and Prevention's Healthy Brain Initiative (HBI) encourages an interdisciplinary approach to ad-dressing the burden of subjective cognitive decline (SCD) among the aging US population as that population continues to increase. Our study is one of the first to evaluate associations between SCD and adverse childhood experiences (ACEs) and other modifiable risk factors to support implementation of the initiative. Methods We used multivariate logistic regression to assess data from the 2020 Behavioral Risk Factor Surveillance System survey to evalu-ate associations between SCD and ACEs scores and sociodemo-graphic, behavioral, and clinical risk factors. Models were weighted to account for the complex survey design. Results Approximately 8.1% of survey respondents reported experiencing SCD within the past 12 months. Adjusted regression analysis showed that conditions such as depression (AOR, 2.85; 95% CI, 2.29-3.55), arthritis (AOR, 1.30; 95% CI, 1.05-1.60), and dia-betes (AOR, 1.33; 95% CI, 1.05-1.68) were significantly associ-ated with SCD. SCD was also associated with experiencing more than 3 falls per year (AOR, 2.95; 95% CI, 2.13-4.09), sleeping more than 9 hours per night (AOR, 2.06; 95% CI, 1.37-3.09), and physical inactivity (AOR, 1.32; 95% CI, 1.03-1.68). Two or more ACEs also significantly increased the odds of SCD (AOR, 1.69; 95% CI, 1.36-2.10). Conclusion Findings from our study can be used to inform policy, environ-ment, and systems change efforts aimed at addressing modifiable risk factors to support healthy aging. The role of ACEs as determ-inants of brain health across the life course should also be con-sidered in the design of clinical and community-based interven-tions.