A lifecourse approach in examining the association between accumulation of adversity and mental health in older adulthood

Abstract

BackgroundThere is evidence for a cumulative effect of adversities on mental health, however, less is known on the accumulating duration of exposure to adversity across the lifecourse on mental health in older adults. MethodsUsing data from the 1946 British birth cohort study (N = 2745), we examined associations between the accumulation of adversity (birth-63 years) and mental health (emotional symptom, life satisfaction, affective wellbeing) in older adults (63–69 years). Accumulation of adversity was assessed as the number of adversities and duration of exposure (number of lifecourse stages exposed to any, economic, psychosocial, or physical adversity). Linear regression tested their association with mental health, adjusted for sex, childhood cognition and emotional problems, and educational attainment. ResultsIncreased number of adversities was associated with increased emotional symptoms (β = 0.08 [0.06, 0.10]), decreased life satisfaction (β = −0.14 [−0.16, −0.12]) and decreased affective wellbeing (β = −0.08 [−0.10, −0.06]). Each additional duration of exposure was associated with a 0.38 [0.12, 0.65] standard deviation (SD) increase in emotional symptoms, and a − 0.68 [−0.96, −0.39] and −0.43 SD [−0.68, −0.18] decrease in life satisfaction and affective wellbeing, respectively. Life satisfaction showed stronger associations with economic and psychosocial compared to physical adversity. LimitationsSome limitations include selective drop-out and lack of ethnic diversity. ConclusionsEfforts to improve mental health in older adults should focus on reducing the number of adversities, as well as considering previous exposure across different lifecourse stages, to prevent adversities from becoming chronic. Future research should also consider the clustering and co-occurrence of different adversities across the lifecourse.