Adverse childhood experiences and age-trajectories of depressive symptom for middle and older ages

Abstract

Abstract Background Adverse childhood experiences (ACEs) have lifelong impacts on health outcomes. Less is known about their effects on later outcomes (mental health). Moreover, associations of ACEs with age-trajectories of depressive symptoms and how they differ in different countries remain unclear. We investigated associations between ACEs and trajectories of depressive symptoms at mid-to-older ages in two distinct populations. Methods We used longitudinal data from English Longitudinal Study of Ageing (ELSA: n = 19602, ≥50y) and China Health and Retirement Longitudinal Study (CHARLS: n = 19561, ≥45y). Depressive symptoms were measured by Center for Epidemiologic Studies Depression scale at 10 waves (2002-2022) in ELSA and at 5 waves (2011-2020) in CHARLS. ACEs were retrospectively reported in both studies. We applied group-based trajectory modelling to identify distinct age-trajectories of depressive symptoms and multinomial regression to estimate associations between ACEs and trajectory groups. Results We identified three trajectory groups: in ELSA: high (12.3% in men and 14.7% in women), moderate (46.6% and 47.9%) and low (41.1% and 37.4%), and in CHARLS: high (9.3% and 13.2%), moderate (34.1% and 39.4%) and low (56.6% and 47.4%). Most ACEs were associated with increased risk of having moderate/ high trajectories of depressive symptoms after adjusting for other ACEs, sex, and childhood socioeconomic disadvantages. For example, for physical abuse, the adjusted relative risk ratio (RRRadj) for high and moderate trajectory groups was 2.09(1.99, 2.19) and 1.16(1.12, 1.20) respectively in ELSA. It was 1.34(1.23, 1.44) and 1.22(1.13, 1.32) in CHARLS. For domestic violence, the respective RRRadj was 1.90(1.65, 2.18) and 1.44(1.22, 1.70) in ELSA, and 1.33(1.22, 1.44) and 1.24(1.14, 1.35) in CHARLS. Conclusions ACEs have life-long effects on mental health at mid-to-older ages in both countries, highlighting the need of early intervention to improve mental health in later life. Key messages • Our work considered the distinct patterns of age-trajectories of depressive symptoms for adults at middle and older ages, capturing the changing process of mental health problems in later life. • We also investigated the associations between childhood factors and trajectory of depressive symptoms, which helped to improve mental health for older people under the situation of global ageing.