1 Department of Psychology, University of Toronto, Toronto, Canada.
2 Centre for Addiction and Mental Health, Toronto, Canada.
3 Department of Psychology, Concordia University, Montreal, Canada.
4 Tema Genus, Linköping University, Linköping, Sweden.
5 Rotman Research Institute, Baycrest Hospital, Toronto, Canada.

Introduction: Women make up two-thirds of people with Alzheimer's disease (AD). Research has focused on biological explanations for this sex difference, while contributions of psychosocial risk factors are less well understood.

Methods: We examined sex differences in the effects of adverse childhood experiences (ACEs) on late-life cognition in groups along a continuum of AD risk: cognitively unimpaired controls (CU; n = 128), subjective cognitive decline (SCD; n = 113), mild cognitive impairment (MCI; n = 241), and AD (n = 77), from the Canadian Consortium on Neurodegeneration in Aging Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study.

Results: Women reported more ACEs than men. There were negative associations between ACEs and hippocampal and prefrontal cortical volumes in CU men and prefrontal volumes in men with SCD. In MCI, ACEs were linked to poorer executive function and associative memory in women. No ACE-related effects were found in AD.

Discussion: ACEs may have enduring effects on late-life cognition that differ between men and women and vary by cognitive status.