OBJECTIVES: This study examined the longitudinal association between a prior history of sexual assault (SA), typically in youth, and decreasing executive functioning (EF) in old age and whether the apolipoprotein (APOE) ε4 allele modifies this relationship. METHOD: In this longitudinal study, 846 community-dwelling older adults at baseline completed questions about SA history and two tests of EF. Over the 10 years following this baseline visit, participants completed up to 3 follow-up cognitive assessments. Mixed-effects models first examined the longitudinal association between SA and EF performance. Last, preplanned analyses examined whether the APOE ε4 allele modified this association. RESULTS: A single SA exposure was not associated with EF declines. Repeated SA exposure was associated with steeper declines in both EF measures. For Trails B, there was a significant interaction between any SA exposure and the APOE ε4 allele, such that having either repeated or isolated SA as well as APOE ε4 was associated with faster decline. DISCUSSION: SA exposure earlier in life may increase risk for declines in EF 50-60 years later in old age, particularly in the context of the APOE ε4 allele. These results generally support a diathesis-stress model of decreased cognitive reserve.
OBJECTIVES: This study examined the longitudinal association between a prior history of sexual assault (SA), typically in youth, and decreasing executive functioning (EF) in old age and whether the apolipoprotein (APOE) ε4 allele modifies this relationship. METHOD: In this longitudinal study, 846 community-dwelling older adults at baseline completed questions about SA history and two tests of EF. Over the 10 years following this baseline visit, participants completed up to 3 follow-up cognitive assessments. Mixed-effects models first examined the longitudinal association between SA and EF performance. Last, preplanned analyses examined whether the APOE ε4 allele modified this association. RESULTS: A single SA exposure was not associated with EF declines. Repeated SA exposure was associated with steeper declines in both EF measures. For Trails B, there was a significant interaction between any SA exposure and the APOE ε4 allele, such that having either repeated or isolated SA as well as APOE ε4 was associated with faster decline. DISCUSSION: SA exposure earlier in life may increase risk for declines in EF 50-60 years later in old age, particularly in the context of the APOE ε4 allele. These results generally support a diathesis-stress model of decreased cognitive reserve.
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