Childhood Adversity as a Risk Factor for Dementia: Family Dysfunction and the Change in Phosphorylated Tau Among Middle-Aged Black American Women

While adverse childhood experience is a strong social determinant of health for multiple later life outcomes, its effect on the risk of dementia remains unclear. Using 20-year longitudinal data from middle-aged Black American women, we employed a path modeling approach to examine the direct effect of family childhood adversity on changes in phosphorylated tau 181 (p-tau 181) levels, a biomarker associated with Alzheimer’s disease risk. Our results revealed that experiencing more familial trauma in childhood predicted higher p-tau 181 levels over time, suggesting an elevated risk of Alzheimer’s disease. Additionally, childhood adversity was positively linked to a higher number of chronic illnesses in adulthood but did not mediate its effect on p-tau levels. These findings extend the sensitive period model in the life course perspective, demonstrating that childhood is a critical period shaping later-life cognitive health.