Abstract
BackgroundAdverse childhood experiences (ACEs) have been associated with both inflammation and depression. However, few studies have examined the role of inflammation as a possible biological mechanism underlying the association of ACEs with depression in later life using longitudinal data. This study investigated the longitudinal mediation effects of inflammation in the relationship between ACEs and depressive symptoms in older adults. MethodsWe utilised data from the English Longitudinal Study of Ageing (N = 4382). ACEs (i.e. threat, family dysfunction, low parental bonding, loss experiences) were assessed retrospectively at wave 3 (2006/07). C-reactive protein (CRP), an inflammatory marker, was measured at waves 2 (2004/05), 4 (2008/09), and 6 (2012/13). Depressive symptoms were ascertained from wave 6 to 8 (2016/17). The mediation analysis was conducted using parallel process latent growth curve modelling. ResultsGreater ACEs cumulative exposure was associated with higher CRP and depressive symptoms at baseline (βCRPi = 0.066[0.030–0.102]; βDEPi = 0.149[0.115–0.183]) and with their increase over time (βCRPs = 0.205[0.095–0.315]; βDEPs = 0.355[0.184–0.526]). Baseline CRP levels were positively associated with baseline depressive symptoms (βDEPi = 0.145[0.104–0.186]) and their trajectory (βDEPs = 0.215[0.124–0.306]). The mediation analysis indicated that higher baseline CRP levels mediated respectively 7% and 5% of the total effect of ACEs cumulative exposure on the baseline value and change in depressive symptoms. These mediation effects were larger for Loss experiences (i.e. 20% and 12% respectively) than for other types of ACEs. In addition, they were independent of possible confounders and additional mediators including adult socioeconomic position and lifestyle factors. ConclusionACEs were related to higher depressive symptoms partly via elevated CRP levels. Inflammation might be one of the psychobiological mechanisms underlying the link between ACEs and depression. Psychosocial and behavioural interventions to prevent and reduce the negative impact of ACEs might help to lower the risk of inflammation and depression in the population.
Highlights
Depression is the predominant mental disorder across the world affecting > 300 million people globally (Patel, 2016)
These results indicate that baseline Creactive protein (CRP) levels mediated 7% and 5% of the association of Adverse childhood experiences (ACEs) with the intercept and slope of depressive symptoms respectively, independently of possible confounders and additional mediators
We found significant differences in socioeconomic, health, and lifestyle characteristics between the subsample of English Longitudinal Study of Ageing (ELSA) participants included in the study and those excluded owing to insufficient data
Summary
Depression is the predominant mental disorder across the world affecting > 300 million people globally (Patel, 2016). The mediation analysis indicated that higher baseline CRP levels mediated respectively 7% and 5% of the total effect of ACEs cumulative exposure on the baseline value and change in depressive symptoms. These mediation effects were larger for Loss experiences (i.e. 20% and 12% respectively) than for other types of ACEs. These mediation effects were larger for Loss experiences (i.e. 20% and 12% respectively) than for other types of ACEs They were independent of possible confounders and additional mediators including adult socioeconomic position and lifestyle factors. Psychosocial and behavioural interventions to prevent and reduce the negative impact of ACEs might help to lower the risk of inflammation and depression in the population
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