Symptoms In Later Life Research Articles

Association between sleep duration from midlife to late life and the risk of depressive symptoms: the Singapore Chinese Health Study.

The prospective association between sleep duration and the development of late-life depressive symptomology is unclear. To investigate sleep duration from midlife to late life in relation to risk of depressive symptoms in late life. A total of 14 361 participants from the Singapore Chinese Health Study were included in the present study. Daily sleep duration was self-reported at baseline (mean age of 52.4 years; 1993-98), follow-up 2 (mean age of 65.2 years; 2006-10) and follow-up 3 (mean age of 72.5 years; 2014-16) interviews. Depressive symptoms were evaluated using the Geriatric Depression Scale at follow-up 3 interviews. Modified Poisson regression models were performed to estimate relative risks and 95% confidence intervals of late-life depressive symptoms in relation to sleep duration at baseline and the two follow-up interviews. Compared with sleeping 7 h per day, a short sleep duration of ≤5 h per day at baseline (i.e. midlife) was related to a higher risk of depressive symptoms (relative risk 1.10, 95% CI 1.06-1.15), and this risk was not affected by subsequent prolongation of sleep. Conversely, a long sleep duration of ≥9 h per day at baseline was not related to risk of depressive symptoms. At follow-up 3 (i.e. late life), both short sleep (relative risk 1.20, 95% CI 1.16-1.25) and long sleep (relative risk 1.12, 95% CI 1.07-1.18) duration were cross-sectionally associated with depressive symptoms. Short sleep duration in midlife, regardless of subsequent prolongation, is associated with an increased risk of depression in late life. Contrariwise, both short and long sleep duration in late life co-occur with depressive symptoms.

Latent profile analysis of biopsychosocial measures in older patients with (un)explained persistent somatic symptoms

Patients with persistent somatic symptoms (PSS) often receive either somatic or psychiatric care, depending on whether symptoms are respectively medically explained (MES) or unexplained (MUS). This separation may not be as clinically relevant as previously assumed; however, research on data-driven subgroups within cohorts of older patients with PSS is not available. Our goal is to identify more clinically relevant homogeneous subgroups beyond the distinction of MUS and MES among older patients with PSS by using a data-driven approach. We performed two Latent Profile Analyses (LPAs), one focused on 6 somatic health measures, the other on 6 psychosocial measures, using data from a case-control study with participants (>60 years) with MUS (N = 118) or MES (N = 154), recruited from the general public, general practices and secondary healthcare. We identified two somatic-health based (strong, vulnerable) and four mental-health based (strong, vulnerable, lonely, non-acceptance) profiles. We found no statistically significant overlap between the somatic – and mental health profiles (κ = 0.019). Health related quality of life negatively associated with the mentally – and somatically vulnerable profiles. We conclude that singular focus on MUS/MES distinction in the care for older PSS patients may lead to undertreatment of the most vulnerable patients. Integrated care is recommended when treating persistent somatic symptoms in later life, regardless of the (un)explained origin of the symptoms.

Adverse childhood experiences, marital status and depressive symptoms in later life among the Chinese middle-aged and older adults : the mediating role of marital status

BackgroundMany studies have shown that adverse childhood experiences (ACEs) lead to adverse social relations in middle-aged and older adults and harm physical and mental health, but few studies have focused on the impact of ACEs on marital status in middle-aged and older adults and the potential influence of marital status between ACEs and depressive symptoms.PurposeThis study aimed to analyze the effect of ACEs on marital status and depressive symptoms in the Chinese middle-aged and older adults, and to explore the mediating role of marital status in the association between ACEs and depressive symptoms in middle-aged and older adults.MethodThis study used the China Health and Retirement Longitudinal Study (CHARLS) 2014 life history survey and 2015 and 2018 follow-up data to analyze, ten ACEs conditions and marital status were collected by questionnaire, using the Center for Epidemiological Studies Depression Scale (CESD-10) 10-item short form to assess depressive symptoms. The association between cumulative ACEs and marital status was assessed by constructing a multinomial logistic regression (MLR) model, as well as a binary logistic regression model to assess the association between ACEs and depressive symptoms. The mediating role of marital status in the association between ACEs and depressive symptoms was also assessed.ResultsA total of 10,246 individuals aged 45 years or older were included in the analysis. Compared to individuals who did not experience ACEs, those who experienced two or more ACEs had a higher risk of being unmarried (seperated/divorced/never married) (OR = 1.67, 95% CI=[1.10,2.51]) and a higher risk of depressive symptoms (OR = 1.66, 95% CI=[1.49,1.84]) in middle and old age. Unmarried status partially mediated the association of ACEs with depressive symptoms.ConclusionChinese middle-aged and older people who experienced two or more ACEs have higher risks of unmarried status and depressive symptoms, and unmarried status partially mediated the ACEs-depressive symptom association. These findings reveal the fact that we need to develop life-cycle public health strategies to reduce exposure to ACEs and society should give more attention to the marital status of older people, thereby reducing the risk of depression among middle-aged and older adults in China.

Childhood intra- and extra-familial maltreatment and later-life trajectories of depressive symptoms: evidence from China

BackgroundBoth late-life depression and childhood maltreatment have become major global public health issues, given their prevalence and social-economic and health consequences. However, previous studies have solely focused on the relationship of childhood maltreatment to average levels of depressive symptoms. The current study addresses this gap of knowledge by simultaneously examining the impacts of childhood intra- and extra-familial maltreatment on age trajectories of depressive symptoms in later life in the Chinese context.MethodsHierarchical linear models were applied to data from the China Health and Retirement Longitudinal Study (2011–2018, N = 12,669 individuals aged 45 to 80, comprising N = 43,348 person-years). Depressive symptoms were measured by the CES-D-10 scale. Childhood intra-familial maltreatments were measured by physical abuse and emotional neglect, while extra-familial maltreatment was measured by peer bullying. All analyses were conducted separately by gender in Stata 16.ResultsChildhood extrafamilial peer bullying (β = 1.628, p < 0.001), and intrafamilial physical abuse (β = 0.746, p < 0.001) and emotional neglect (β = 0.880, p < 0.001) were associated with higher later-life depressive symptoms levels in the whole sample. Peer bullying differences in depressive symptoms widened with age for both men and women. Physical abuse differences in depressive symptoms remained stable over the life course among men but increased among women. Emotional neglect differences in depressive symptoms decreased with age among men, while it increased first and then decreased among women.ConclusionsFindings in this study suggest that childhood maltreatment is not only associated with later-life poorer mental health but contributes to increasing inequalities in mental health as people age, especially among peer-bullying victims and women.

Association between Dietary Antioxidant Capacity in Midlife and Depressive Symptoms in Late Life: The Singapore Chinese Health Study.

Preclinical and limited epidemiological studies suggest that oxidative stress may be implicated in geriatric depression. Our study investigated the association between midlife dietary total antioxidant capacity (TAC) and depressive symptoms in late life among 13,712 participants in a population-based cohort of Chinese in Singapore. At baseline (1993-1998), intake of antioxidants from diet and supplements at a mean age of 52.4 years was estimated using a validated food frequency questionnaire to derive two dietary TAC indices from vitamins C and E, carotenoids and flavonoids: the Comprehensive Dietary Antioxidant Index (CDAI) and Vitamin C Equivalent Antioxidant Capacity (VCEAC). At follow-up 3 (2014-2016), when participants were at a mean age of 72.5 years, depressive symptoms were assessed using the Geriatric Depression Scale, and depression, defined as having ≥5 symptoms, was presented in 3173 (23.1%) participants. Both CDAI and VCEAC indices were inversely associated with odds of depressive symptoms in a stepwise manner: the OR (95% CI) comparing the extreme quartiles was 0.73 (0.64-0.83; Ptrend < 0.01) for the CDAI and 0.77 (0.68-0.87; Ptrend < 0.01) for the VCEAC. Specifically, higher intakes of vitamin C, carotenoids, and flavonoids were associated with a lower likelihood of depressive symptoms. Our findings support the recommendation of an antioxidant-rich diet for the prevention of depression.

Gut microbiome predicts cognitive function and depressive symptoms in late life

Depression in older adults with cognitive impairment increases progression to dementia. Microbiota is associated with current mood and cognition, but the extent to which it predicts future symptoms is unknown. In this work, we identified microbial features that reflect current and predict future cognitive and depressive symptoms. Clinical assessments and stool samples were collected from 268 participants with varying cognitive and depressive symptoms. Seventy participants underwent 2-year follow-up. Microbial community diversity, structure, and composition were assessed using high-resolution 16 S rRNA marker gene sequencing. We implemented linear regression to characterize the relationship between microbiome composition, current cognitive impairment, and depressive symptoms. We leveraged elastic net regression to discover features that reflect current or future cognitive function and depressive symptoms. Greater microbial community diversity associated with lower current cognition in the whole sample, and greater depression in participants not on antidepressants. Poor current cognitive function associated with lower relative abundance of Bifidobacterium, while greater GABA degradation associated with greater current depression severity. Future cognitive decline associated with lower cognitive function, lower relative abundance of Intestinibacter, lower glutamate degradation, and higher baseline histamine synthesis. Future increase in depressive symptoms associated with higher baseline depression and anxiety, lower cognitive function, diabetes, lower relative abundance of Bacteroidota, and lower glutamate degradation. Our results suggest cognitive dysfunction and depression are unique states with an overall biological effect detectable through gut microbiota. The microbiome may present a noninvasive readout and prognostic tool for cognitive and psychiatric states.

Sense of Freedom in the Golden Years: Disentangling the Complex Ties Between Community Safety Concerns and Depressive Symptoms in Later Life.

This study investigates the "Negative Spillover Effect"-a conceptual framework that highlights the correlation between older adults' community safety concerns and depressive symptoms. It explores the moderating influence of the sense of freedom in this relationship. Through the analysis of data from 3408 participants in the China Labor-force Dynamics Survey, employing a two-stage least squares regression approach, the study uncovers the intricate role of the sense of freedom in influencing the depressive symptoms of older adults based on their community safety concerns. The sense of freedom serves as a protective factor against the adverse psychological effects of community safety concerns when they are strong. However, this protective role diminishes when coupled with a low perception of the fair match between labor input and living condition rewards. The study underscores the importance of addressing and mitigating the negative spillover effect to foster sustainable and equitable community development. Reducing these adverse effects is essential for enhancing the mental health and well-being of the older demographic.

An Intersectional Approach to Understanding the Psychological Health Effects of Combining Work and Parental Caregiving.

Role theory suggests occupying simultaneous family caregiving and employment roles in midlife may exert positive and negative effects on psychological health. However, there is a lack of causal evidence examining the degree to which combinations of these roles influence psychological health at the intersection of gender and racial identity. Longitudinal data from the Health and Retirement Study (2004-2018) are used to estimate a series of individual fixed effects models examining combinations of employment status and parental caregiving situation on Center for Epidemiological Studies-Depression Scale (CES-D) depression scores among Black and White men and women aged 50-65. Subsequent models were stratified by intensity of caregiving situation and work schedule. Individual fixed effects models demonstrate combining work, and parental caregiving is associated with greater depressive symptoms than only working, and with lower depressive symptoms than only caregiving, suggesting that paid employment exerts a protective effect on psychological health whereas parental caregiving may be a risk factor for depressive symptoms in later life. Analyses using an intersectional lens found that combining paid work with parental caregiving exerted a protective effect on CES-D scores among White women and men regardless of participants' intensity of care situation or work schedule. This effect was not present for Black men and women. Accounting for intersectionality is imperative to research on family caregiving, work, and psychological health.

Association of perceived childhood socio-economic status and health with depressive symptoms among middle-aged and older adults in India: using data from LASI Wave I, 2017–2018

BackgroundChildhood adverse experience has been linked with poor health outcomes across the life course. Nevertheless, whether such an association or direction could be projected to older people’s life remains still unclear and needs to generate more evidence, particularly in India. Therefore, this study was conducted to examine the association of childhood socio-economic status and health with depressive symptoms amongst middle- aged and older adults in India.MethodsThe data for the study was drawn from national representative survey “Longitudinal Ageing Study in India (LASI)” Wave I, 2017–2018 in order to conduct cross-sectional study. Multivariable regression analysis was used to examine the association of childhood socioeconomic status and health with depressive symptoms in the older population.ResultsPoor childhood health was significantly and positively associated with depressive symptoms (AoR: 1.56, CI: 1.19, 2.04). Likewise, respondents who were bedridden for a month during their childhood had high odds of developing depressive symptoms (AoR: 1.16 CI: 1.01, 1.34). In addition to this, the odds of having depressive symptoms increased significantly among the average (AoR: 1.28 CI: 1.08, 1.51) and poor childhood socioeconomic status group (AoR: 1.31 CI: 1.11, 1.55) as compared to the higher socioeconomic category.ConclusionsChildhood socioeconomic status and health have a significant role in determining mental health in later life. Results suggest that considering childhood socioeconomic status and health is important while diagnosing depression in older population in order to identify the significant associated factors in early childhood and thus help in preventing depressive symptoms in later life.

Childhood maltreatment and association with trajectories of depressive symptoms among older adults: a longitudinal study in China

Objectives Childhood maltreatment has long-lasting effects on mental health. Existing evidence suggests that trajectories of depressive symptoms vary among individuals; however, little is known about how childhood maltreatment shapes these trajectory patterns. Therefore, this study investigated the impacts of childhood maltreatment on eight-year depressive trajectories among Chinese older adults. Method Five waves of longitudinal data from the China Health and Retirement Longitudinal Study were utilized. Growth Mixture Modelling was performed to identify distinct trajectories of depressive symptoms, and multinomial logistic regression was conducted to explore the associations between these trajectories and childhood maltreatment. Results Four trajectories of depressive symptoms were identified: the ‘no symptoms’ class (61.83%), the ‘increasing symptoms’ class (14.49%), the ‘decreasing symptoms’ class (16.44%), and the ‘chronic symptoms’ class (7.24%). Older adults who experienced childhood physical abuse were more likely to be in the ‘chronic symptoms’ class than in the ‘no symptoms’ class, whereas emotional neglect did not show a significant association with three problematic trajectories. Conclusion This study provides empirical evidence that childhood physical abuse increases the likelihood of developing chronic depressive symptoms in later life. To mitigate this risk, it is crucial to institute comprehensive treatment plans that incorporate trauma-informed care principles, employ evidence-based therapies specifically designed to address the long-term effects of abuse, and prioritize regular screening and assessment of mental health among older adults.

Long-term effects of childhood difficulties on depressive symptoms among older adults: Role of adulthood income and income satisfaction.

This study examines how childhood difficulties are associated with late-life depression. Using the concept of agency within the structure of the life course perspective, this study investigates how subjective income satisfaction in adulthood plays a role in the relationship between adulthood objective income and late-life depressive symptoms among older adults who have experienced childhood difficulties. Using data from two waves (2006, 2021) of the Korean Welfare Panel Study (N = 1822), we identified respondents with and without childhood difficulties, and performed a series of hierarchical zero-inflated Poisson regression models. Childhood difficulties (β, 0.07; 95% confidence interval [CI], 0.04-0.11), adulthood low income (β, 0.17; 95% CI, 0.13-0.21), and low income satisfaction (β, 0.16; 95% CI, 0.12-0.21) are associated with an increased level of depressive symptoms in late life. In the context of the association between objective income level and late-life depressive symptoms, the buffering effect of income satisfaction in adulthood was found among the respondents who had experienced childhood difficulties (β, 0.22; 95% CI, 0.09-0.34). Childhood difficulties are a critical risk factor impacting late-life psychological well-being. How an individual subjectively evaluates his or her economic status in adulthood plays a major role in mitigating the negative impact of childhood difficulties on late-life health inequality. Interventions to reduce the risk of childhood difficulties and their negative long-lasting impact may alleviate individuals' exposure to depression in late life. Geriatr Gerontol Int 2024; 24: 246-252.

Understanding the Interplay of Religion, Social Relationships, and Depressive Symptoms in Later Life: An Analysis of Dynamics in Individual and Dyadic Contexts.

This study examined how religious participation at the individual level and the dyadic religious similarity at the couple level influenced depressive symptoms via social relationships among older Korean couples aged 65 and above. The sample included 1,191 couples from the seventh assessment of the Korean Longitudinal Study of Ageing. The findings indicated that older adults who participated in religious activities more frequently showed lower levels of depressive symptoms through increased social interactions and marital satisfaction. Additionally, older couples with similar religious backgrounds showed higher levels of marital satisfaction than those without similar religious backgrounds, subsequently leading to lower levels of depressive symptoms. Overall, the associations between religion and depressive symptoms were similar for both genders. The findings provided insights into potential mechanisms leading to later-life depressive symptoms at both the individual and couple levels in terms of religion and social relationships and informed practical implications for older couples' marital relationships.

Lifetime adversity predicts depression, anxiety, and cognitive impairment in a nationally representative sample of older adults in the United States.

Although life stress and adversity are well-known risk factors for mental health problems and cognitive impairment among older adults, limited research has comprehensively examined the impact of both childhood and adulthood adversity on psychiatric and cognitive impairment symptoms over a prolonged period. To address this issue, we investigated how lifetime adversity exposure is related to symptoms of depression, anxiety, and cognitive impairment in a nationally representative, longitudinal sample of older adults in the United States. We analyzed data from the Health and Retirement Study (1992-2016). The sample included 3496 individuals (59.9% female), aged ≥64 years old (Mage = 76.0 ± 7.6 years in 2016). We used the individual-level panel data and ordinary least squares regressions to estimate associations between childhood and adulthood adversities, and later-life depression, anxiety, and cognitive impairment. Many participants experienced a significant early life (38%) or adulthood (79%) stressor. Moreover, experiencing one childhood adversity (vs. none) was associated with a 17.4% increased risk of adulthood adversity. Finally, as hypothesized, childhood adversity exposure was related to experiencing more depression and anxiety symptoms in later life, whereas adulthood stressor exposure predicted more cognitive impairment as well as more depression and anxiety symptoms. These findings demonstrate significant associations between lifetime adversity and symptoms of depression, anxiety, and cognitive impairment in older adults. Screening for lifetime stressors may thus help healthcare professionals and policymakers identify individuals who could potentially benefit from interventions designed to reduce stress and enhance resilience.

Poor mobility and lower limb weakness are associated with three distinct depressive symptom trajectories over 6 years in older people.

Physical decline can be associated with the onset of depressive symptoms in later life. This study aimed to identify physical and lifestyle risk factors for depressive symptom trajectories in community-dwelling older adults. Participants were 553 people aged 70-90 years who underwent baseline physical, psychological and lifestyle assessments. Group-based trajectory analysis was used to identify patterns of depressive symptom development over 6 years of follow-up. Strengths of associations between baseline functional test performances and depressive symptom trajectories were evaluated with univariable ordinal models. Subsequently, the adjusted cumulative odds ratio for the association between identified risk factors, demographic factors and baseline anti-depressant use were measured using multivariable ordinal logistic regression. Three distinct depressive symptom trajectories were identified: a low-and-stable course (10% of participants), a low-and-increasing course (81%) and a moderate-and-increasing course (9%). Timed Up and Go test time was the strongest risk factor of depressive symptom trajectory, followed by Five Times Sit-to-Stand test performance, planned physical activity levels, and knee extension strength (adjusted standardised ORs 1.65, 95% CI 1.34-2.04; 1.44, 95% CI 1.16-1.77; 1.44, 95% CI 1.17-1.76 and 1.41, 95% CI 1.15-1.73 respectively). After adjusting for age, sex, body mass index and baseline anti-depressant use, Timed Up and Go test performance and knee extension strength were independently and significantly associated with depressive trajectories. Timed Up and Go test times, Five Times Sit-to-Stand test performance, planned physical activity levels and knee extension strength are associated with three discrete depressive symptom trajectories. These clinical tests may help identify older adults aged 70-90 years at risk of developing depressive symptoms and help guide subsequent strength and mobility interventions.

Depressive Symptoms in Later Life in China: Situating "Long Arm" of Child Physical Maltreatment Within a Family Context.

Objective: This article intends to reveal the long-term effects of physical maltreatment in childhood on depressive symptoms in later life in China. Methods: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). 8676 respondents aged 45 and older were included in the study. In this study, we use ordinary least squares (OLS) regression models to estimate the long-term impact on children of physical punishment from their parents. Results: We found that individuals who recalled being hit by their mother in early life reported more depressive symptoms than those who recalled being punished by their father. Difficult family contexts (e.g., comparative poverty, family violence, and parent's poor mental health) had a weak association with higher risk of reporting physical maltreatment and more depressive symptoms among respondents in later life. Conclusion: This article extended the exploration of the long-term impact of child physical maltreatment beyond adolescence and into until later adult life. Effective policies to protect children from maltreatment in the form of physical punishment require further attention to the challenges posed by tradition and culture.

CHILDHOOD PARENT–CHILD RELATIONSHIP, PARTNER RELATIONSHIP CLOSENESS, AND DEPRESSIVE SYMPTOMS IN LATER LIFE

Abstract Attachment theory suggests that quality of early-life parent-child relationships may influence how people establish other types of relationships (e.g., romantic relationship, friendship) later in life, and have long-lasting effects on individuals’ psychosocial development. Yet, little research has investigated whether such effects may last until later adulthood and the potential moderators in these processes. To address this issue, this study examined the associations among childhood parent-child relationship quality, current partner relationship closeness, and depressive symptoms in late life using a sample of 12,292 community-dwelling adults aged 51 or older (Mage = 63.15, 51% female). We leveraged the seven-wave longitudinal data between 2006–2018 from the Health and Retirement Study. Depressive symptoms were assessed using the CESD score at each wave. Participants also reported closeness with their partner every other wave, and relationship quality with their parents in childhood. Multilevel models showed that better mother-child and father-child relationships during childhood were both associated with greater closeness with partner in late life, especially for female compared to male. Poorer childhood mother-child relationship was associated more depressive symptoms in late life, but this association was attenuated for those who overall reported a greater level of closeness with their partner over the study period. The findings suggest that negative early life parent-child relationship may put people at greater risk for developing depressive symptoms and weaker social connections in late life, and highlight the protective role of positive partner relationship in buffering this association.

Gut Microbiome Predicts Cognitive Function and Depressive Symptoms in Late Life

AbstractBackgroundDepressive symptoms in older adults with cognitive impairment increase the likelihood of progression to dementia. Current mood and cognitive function associate with microbial composition, but the extent to which the microbiome may predict clinical trajectory is unknown. We investigated the capacity of the gut microbiome to reflect current and predict future cognitive function and depressive symptoms.MethodClinical assessments and stool samples were collected from 268 participants with varying cognitive function and depressive symptoms. Seventy participants underwent a 2‐year follow‐up. Microbial community diversity, structure, and composition was assessed using high‐resolution 16S rRNA marker gene sequencing (Figure 1). We implemented multiple linear regression to characterize the relationship between microbiome composition, current cognitive impairment, and depressive symptoms. We leveraged elastic net regression to discover microbial community metrics and microbial functional pathways that reflect current or predict future cognitive function and depressive symptoms (Figure 2).ResultGreater microbial community diversity, indicating a higher number and even distribution of species within a community, was associated with worse current cognitive function in the sample, as well as greater depression severity in participants not on antidepressants. Poor current cognitive function was associated with lower relative abundance of Bifidobacterium. On a functional level, we demonstrate an association between greater GABA degradation and greater current depression severity (Figure 2). Future cognitive decline was associated with lower cognitive function and increased anxiety at baseline. Future cognitive decline was also associated with decreased relative abundance of Firmicutes and Intestinibacter, higher glutamate degradation, and higher baseline histamine synthesis (Figure 2). Future increase in depressive symptoms was associated with higher baseline depression and anxiety, lower cognitive function, and lower relative abundance of Bacteroidota (Figure 2).ConclusionWe display utility in microbiome composition for predicting future cognitive function and depressive symptoms in late life. Our results suggest the gut microbiome may present a noninvasive prognostic for cognitive and psychiatric states. Advancing our understanding of gut‐brain axis in aging may inform the development of neurobiologically driven interventions to ameliorate cognitive decline and depressive symptoms in late life.

Religious Attendance, Childhood Trauma, and Later Life Depressive Symptoms

AbstractBackgroundOlder adults who experienced childhood trauma are at higher risk of developing depression. Depression is linked with structural changes in the brain and alterations in neurotransmitters and inflammation, placing individuals with depression at 2 times as likely to develop dementia than individuals without depression. A growing body of literature supports religion and spirituality as protective factors for mental health, yet few studies have examined the mediating role of religious attendance on the association between childhood trauma and depressive symptoms in later life. Identifying modifiable protective factors to decrease depression and, potentially, dementia is needed to decrease the growing dementia burden.MethodWe analyzed data from the Health and Retirement Study in 2006‐2012 to examine the mediating role of religious attendance (in 2010) on the association of childhood trauma (in 2008) with later‐life depressive symptoms (in 2012) among older adults in the U.S. (N = 3,240) aged 60 years and older. A mediation analysis was conducted while controlling for covariates: sex, race, education, age, marital status, body mass index (BMI), and cognition.ResultAged 60‐104 years, participants had a mean age of 72.7 (8.45) years, were 57.9% female, and were 82.9% White. A significant association was found for childhood trauma using 4 self‐report items and self‐reported depressive symptoms using the Center for Epidemiological Studies‐Depression scale (CES‐D) (β = 0.2124, 95% CI [0.31, 0.1201], p&lt;.001). There was a partial mediating effect of self‐reported religious attendance (high vs. low) between childhood trauma and depressive symptoms (β = 0.017, 95% CI [0.03, 0.003], p&lt;.05) adjusting for sex, race, education, age, marital status, BMI, and cognition.ConclusionReligious attendance plays a partial mediating role in the relationship between childhood trauma and later‐life depressive symptoms in older adults. Clinical trials are needed to further examine the effect of religious attendance on depressive symptoms in older adults with a history of childhood trauma, with the potential to decrease the risk of dementia.

Fear and avoidance of memory loss: associations with cognitive, psychological and lifestyle factors in mid‐ and later life

AbstractBackgroundAlzheimer’s disease and related dementias (ADRD) are among the most feared conditions. Some level of fear can motivate healthy behaviors. However, intense fears can have the opposite effect, leading to avoidance behaviors such as withdrawal from cognitively or socially demanding activities. In this way, fears and avoidance behaviors have potential to influence modifiable ADRD risk. Here, we investigated if fear and avoidance are associated with cognitive, psychological and lifestyle factors in mid‐ and later life.MethodsParticipants were middle‐aged (n = 188, 40‐59 years, mean = 51.4 ± 5, 52.7% female) and older adults (n = 746, 60‐90 years, mean = 65 ± 7.2, 61.5% female). Fears and avoidance behaviors were measured using Fear and Avoidance of Memory Loss scale. Linear regression examined the contribution of fear and avoidance to cognitive, psychological and lifestyle factors. Mid‐life factors included cognition (COGNITO), stress (Perceived Stress Scale), depressive symptoms (Center for Epidemiologic Studies Depression Scale), loneliness (UCLA Loneliness Scale) and lifestyle activities (Lifetime of Experiences Questionnaire). Later life factors included cognition (MoCA) and depression (Geriatric Depression Scale). Models were adjusted for age, gender, education, ADRD family history and anxiety.ResultsMiddle‐aged and older women reported higher fear compared to men (ps &lt; .028). Older individuals with a family history of ADRD also reported higher fear (p &lt; .001). Avoidance behaviors were significantly associated with worse cognitive performance in later life (β = ‐0.10, p = .020), but not in mid‐life. Greater avoidance in mid‐life was associated with higher stress (β = .83, p = .001), loneliness (β = 1.22, p &lt; .001) and depressive symptoms (β = 1.09, p &lt; .001), and lower engagement in lifestyle activities (β = ‐0.19, p = .02). Avoidance was also associated with depressive symptoms in later life (β = .28, p &lt; .001).ConclusionsAvoidance behaviors were associated with lower engagement in healthy lifestyle activities in mid‐life, worse cognitive performance in later life, and reduced psychological well‐being in both mid‐ and later life. While causation cannot be determined, it is likely that these factors interact recursively over time. Thus, targeting avoidance early on may be beneficial for ADRD risk reduction.

A Link between Prenatal Stage of Life during the Great Chinese Famine and Subsequent Depressive Symptoms among Middle-Aged and Older Adults

Prenatal malnutrition may increase the risk of depressive symptoms in adulthood. This study investigated the association between prenatal exposure to malnutrition with risk of depressive symptoms in middle-aged and older adults using the Chinese Great Famine of 1959–1961 as a natural experiment. Data were obtained from the China Health and Retirement Longitudinal Study baseline survey (2011). A total of 5391 individuals born from 1956 to 1965 were included in the study. Depressive symptoms were ascertained via the Center for Epidemiological Studies Depression Scale short form. Famine severity was measured using the cohort size shrinkage index. Difference-in-differences models were used to explore the association between prenatal famine exposure and later-life depressive symptoms. Compared with the post-famine cohort (1963–1965), famine cohorts (1959–1962) were 4.74 times (95% CI = 1.28–8.20) as likely to develop depressive symptoms. The stratified analysis found that prenatal exposure to famine was associated with depressive symptoms in rural residents but not those living in urban areas. In rural females, prenatal malnutrition was associated with a higher risk of depressive symptoms. However, there was no significant association between prenatal malnutrition and depressive symptoms in rural males. Our results indicated that prenatal malnutrition may contribute to a higher risk for depressive symptoms in later life among female rural residents.