Abstract
BACKGROUND: Childhood adversity has profound implications for cognitive health, with particularly pronounced impacts in minoritized populations. We apply an intersectionality framework to explore how distinct overlapping patterns of adverse childhood experiences (ACEs) influence cognition and cognitive status in older Black adults, considering the potential mediating role of inflammatory pathways. METHODS: Participants included 536 individuals without dementia from the Minority Aging Research Study. Cognition was assessed using episodic memory, semantic memory, and perceptual speed tasks. 145 participants had available data on CRP and composite measures of vascular inflammation (IL-6R, MMP9, VCAM) and HPA-axis dysregulation-related markers (IL-6, IL-1β, TNF-α). These markers were examined as mediators of the associations between ACEs profiles and cognition and cognitive status. RESULTS: Latent profile analysis identified four distinct ACEs profiles: financial strain, parental conflict, severe adversity, and low adversity. The financial strain group demonstrated lower episodic memory (β = -0.093, 95 % CI [-0.182, -0.003], p = 0.043), compared to the low adversity group; this association was not mediated by inflammation levels. Unexpectedly, the severe adversity group exhibited lower levels of HPA axis dysregulation-related inflammation (β = -0.153, 95 % CI [-0.258, -0.048], p = 0.004), compared to the low adversity group. CONCLUSIONS: Distinct ACEs profiles were significantly associated with episodic memory and HPA dysregulation-related inflammation. The severe adversity, parental conflict, and low adversity groups showed no reliable predictions to cognition or cognitive status. These findings highlight the need for careful consideration of timing, measurement, and potential adaptive mechanisms when examining inflammatory pathways that associate childhood adversity with cognitive aging in older Black adults.