The Impact of Adverse Childhood Experiences on Cognitive Function in Middle-Aged and Older Adults: Mediating Roles of Social Isolation and Functional Limitations

Background Adverse childhood experiences (ACEs) are among the factors affecting cognitive function in middle-aged and older adults, but the combined effects of ACEs, social isolation and functional limitations on cognitive function have not been fully explored. Methods This study used data from 6,412 middle-aged and older adults from the 2018 China Health and Retirement Longitudinal Study (CHARLS) and the 2014 CHARLS Life Histories Survey. Mplus 8.0 software was used to construct a structural equation model with ACEs as the independent variable, cognitive function as the dependent variable, and social isolation and functional limitations as mediating variables. Results In this study, ACEs were positively associated with social isolation and functional limitations (r = 0.081, 0.070, P < 0.01) and negatively associated with cognitive function (r=-0.132, P < 0.01). Social isolation and functional limitations had chain mediating effects on the relationship between ACEs and cognitive function. Conclusions ACEs lead to impaired cognitive functioning in middle-aged and older adults, and social isolation and functional limitations influence this relationship. These findings suggest that promoting social integration and physical exercise targeting functional limitations may be important approaches for preventing and mitigating the effects ACEs on cognitive function.