# Adverse childhood experiences and subsequent impact on adulthood cognitive impairment: a systematic review and meta-analysis

## TL;DR

This study reviews how childhood trauma may be linked to cognitive problems in adults, but more research is needed to confirm a direct cause.

## Contribution

The paper provides a meta-analysis of the relationship between adverse childhood experiences and adult cognitive impairment.

## Key findings

- Higher CTQ total scores and emotional neglect were associated with cognitive impairment.
- In adults under 65, ACEs showed a significant link to cognitive impairment.
- Publication bias was unlikely, but limited by the small number of studies.

## Abstract

Cognitive impairment is a significant threat to adult quality of life. Adverse childhood experiences (ACEs) may have prolonged effects on cognitive impairment in adulthood. This systematic review and meta-analysis aimed to investigate the association between ACEs and adult-onset cognitive impairment.

We systematically searched databases, including PubMed, Embase, Web of Science, and the Cochrane Library, from inception through February 16, 2025. Two independent investigators conducted literature screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Meta-analysis was performed applying RevMan5.4.1.

Four studies- two cross-sectional studies, one cohort study, and one case-control study-were included. Meta-analysis results indicated that the Childhood Trauma Questionnaire (CTQ) total score (mean difference [MD]= 7.06, 95% confidence interval [CI] [0.87,13.24], p = 0.03), emotional neglect (MD = 2.88, 95%CI [0.39, 5.37], p = 0.02) were related to cognitive impairment. In the <65-year group, the MD = 2.59 (95%CI [0.09, 5.09], p = 0.04) was associated with cognitive impairment. The funnel diagram of gender analysis was approximately symmetrical visually, indicating a small possibility of publication bias; but due to the small number of studies, the test power was limited.

Adverse childhood experiences may be associated with an increased risk of cognitive impairment, but a causal relationship could not be established owing to limited observational evidence.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420250655749, identifier CRD420250655749.