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Cognitive function following early life war-time stress exposure in a cohort of Vietnamese older adults

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Listed:
  • Korinek, Kim
  • Zimmer, Zachary
  • Teerawichitchainan, Bussarawan
  • Young, Yvette
  • Cao Manh, Long
  • Toan, Tran Khanh

Abstract

Although Alzheimer's Disease is a leading cause of death in Vietnam and other post-conflict, low- and middle-income countries, aside from studies of veterans in western populations, research on war-related violence and deprivation as risk factors for cognitive disorders remains sparse. Using data from the Vietnam Health and Aging Study, which relied upon a multistage probability sample of 2447 older adults residing in districts of northern Vietnam differentially exposed to wartime bombing and numerous war-related stressors, this paper investigates associations between early-life war-related stressors and later-life cognitive function in a cohort whose transition to adulthood took place during the American-Vietnam War. Relationships among experiences of severe childhood hunger, war-related violence and environmental hardships, military service, and cognitive function in an analytical sample of 2162 Vietnamese older adults are estimated using quantile regression. Cognitive function is assessed by a modified Mini-Mental State Examination (MMSE) score. Analyses also address posttraumatic stress disorder (PTSD), cardiovascular health, and health behaviors as potential mediators between early life war-related stressors and current cognitive function. Results indicate that experiences of severe hunger in childhood and environmental hardships are associated with poorer cognitive function in older adulthood. PTSD, cardiovascular risk (i.e., hypertension) and disease (i.e., stroke), each of which is heightened by exposure to wartime stressors, are associated with lower cognitive scores. Results suggest that certain war exposures, like involvement in combat duties, are associated with higher cognitive function scores, suggesting that military service either positively selects for cognitive function, or certain forms of service may impart cognitive resilience. Following recent calls to incorporate population-specific stressors to advance explanatory models of cognitive function, these findings suggest that it is critical to assess the enduring scars and resilience of armed conflict in global efforts to understand, prevent, and treat cognitive impairment, Alzheimer's Disease, and related dementias.

Suggested Citation

  • Korinek, Kim & Zimmer, Zachary & Teerawichitchainan, Bussarawan & Young, Yvette & Cao Manh, Long & Toan, Tran Khanh, 2024. "Cognitive function following early life war-time stress exposure in a cohort of Vietnamese older adults," Social Science & Medicine, Elsevier, vol. 349(C).
    • Handle: RePEc:eee:socmed:v:349:y:2024:i:c:s0277953624002442
    DOI: 10.1016/j.socscimed.2024.116800
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    References listed on IDEAS

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    1. Gretchen L. Birbeck & Ana-Claire Meyer & Adesola Ogunniyi, 2015. "Nervous system disorders across the life course in resource-limited settings," Nature, Nature, vol. 527(7578), pages 167-171, November.
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    3. Nicola Orsini & Matteo Bottai, 2011. "Logistic quantile regression in Stata," Stata Journal, StataCorp LP, vol. 11(3), pages 327-344, September.
    4. Korinek, Kim & Young, Yvette & Teerawichitchainan, Bussarawan & Kim Chuc, Nguyen Thi & Kovnick, Miles & Zimmer, Zachary, 2020. "Is war hard on the heart? Gender, wartime stress and late life cardiovascular conditions in a population of Vietnamese older adults," Social Science & Medicine, Elsevier, vol. 265(C).
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