The relationship between self-reported adverse experiences and depressive symptoms among middle-aged and elderly individuals: A longitudinal study based on the CHARLS database

IF 3.7 Q2 IMMUNOLOGY

Brain, behavior, & immunity - health Pub Date : 2025-04-22 DOI:10.1016/j.bbih.2025.101001

Feng Jiang , Xifei Guan , Zhixin Zhu , Nawen Liu , Hua Gu , Xiuyang Li

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Abstract

Background

Adverse experiences are critical determinants of late-life depressive symptomatology. Understanding how these experiences influence later-life health outcomes remains a research priority. This study examines the longitudinal associations between self-reported adverse childhood experiences (ACEs) and adverse adult experiences (AAEs) with depressive symptoms in older adults, as well as the underlying mechanisms.

Methods

A sample of 3941 adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS) was analyzed. K-means for Longitudinal Data (KML), Logistic regression, and Bayesian Kernel Machine Regression (BKMR) models were employed to assess the effects of adverse experiences. Subgroup and mediation analyses were also performed.

Results

The high depressive symptomatology cluster (n = 1432) demonstrated significant associations with six ACEs: childhood hunger (OR = 1.23, 95%CI:1.03–1.47), dangerous growth environments (OR = 1.34, 95%CI:1.09–1.65), childhood loneliness (OR = 1.45, 95%CI:1.20–1.74), bullying (OR = 1.2, 95%CI:1.01–1.43), parental depression (OR = 1.80, 95%CI:1.50–2.16), and parental disability (OR = 1.44, 95%CI:1.03–2.02). Comprehensive effect estimation of ACEs indicated an 85.9% probability of a high depression score for those with all adverse experiences. AAEs like prolonged bed rest (OR = 1.39, 95%CI:1.08–1.79), and lifetime discrimination (OR = 1.37, 95%CI:1.12–1.66) independently predicted symptom severity. Effect modification analysis revealed stronger ACE impacts among individuals with higher cognitive reserve (OR = 3.32, 95%CI:2.34–4.70). Mediation analysis identified arthritis or rheumatism as a partial mediator of the ACE-depression pathway (natural indirect effect = 1.04, 95%CI:1.02–1.05).

Conclusions

Self-reported ACEs and AAEs demonstrate persistent associations with depressive symptoms in later life, mediated by chronic morbidity and moderated by cognitive reserve.

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中老年个体自我报告不良经历与抑郁症状之间的关系：基于CHARLS数据库的纵向研究

不良经历是晚年抑郁症状的关键决定因素。了解这些经历如何影响晚年的健康结果仍然是研究的重点。本研究探讨了自我报告的童年不良经历（ace）和成人不良经历（AAEs）与老年人抑郁症状之间的纵向关联，以及潜在的机制。方法对来自中国健康与退休纵向研究（CHARLS）的3941名年龄≥45岁的成年人样本进行分析。采用K-means纵向数据（KML）、Logistic回归和贝叶斯核机回归（BKMR）模型来评估不良经历的影响。还进行了亚组分析和中介分析。结果高抑郁症状群（n = 1432）与儿童饥饿（OR = 1.23, 95%CI: 1.03-1.47）、危险生长环境（OR = 1.34, 95%CI: 1.09-1.65）、儿童孤独（OR = 1.45, 95%CI: 1.20-1.74）、欺凌（OR = 1.2, 95%CI: 1.01-1.43）、父母抑郁（OR = 1.80, 95%CI: 1.50-2.16）、父母残疾（OR = 1.44, 95%CI: 1.03-2.02） 6种ace有显著相关性。ace的综合效应估计表明，所有不良经历的患者抑郁得分高的概率为85.9%。ae如延长卧床休息（OR = 1.39, 95%CI: 1.08-1.79）和终生歧视（OR = 1.37, 95%CI: 1.12-1.66）独立预测症状严重程度。效应修正分析显示，认知储备水平高的个体对ACE的影响更大（OR = 3.32, 95%CI:2.34 ~ 4.70）。中介分析确定关节炎或风湿病是ace抑制途径的部分中介（自然间接效应= 1.04,95%CI: 1.02-1.05）。结论自我报告的ace和ae与晚年抑郁症状持续存在关联，这种关联由慢性发病介导，并受认知储备调节。

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