Childhood adversity and major depression in later life: A competing-risks regression analysis

Abstract

Objectives: This study examined the relationship between childhood adversities and major depression in older adults over 8 years.

Methods: The study sample consisted of 16 946 participants aged 51 years and older from the US Health and Retirement Study. Major depression was assessed using the Composite International Diagnostic Interview. Competing-risks regression analysis was conducted to examine the impact of each childhood adversity on late-life major depression and the potential moderation effects of sex, race/ethnicity, and adulthood trauma.

Results: After controlling for covariates, childhood adversities including physical abuse by a parent (subdistribution hazard ratio [SHR] = 1.67, 95% confidence interval [CI] = 1.49-1.89, P < .001), trouble with the police (SHR = 1.31, 95% CI = 1.13-1.54, P = .001), receiving help because of financial difficulties (SHR = 1.17, 95% CI = 1.05-1.31, P = .006), and parental substance abuse (SHR = 1.11, 95% CI = 1.01-1.23, P = .037) were associated with a higher rate of major depression in later life. The association of physical abuse and major depression was stronger for men than women (SHR = 1.46, 95% CI = 1.15-1.85, P = .002), despite an overall lower risk of major depression among men. Potential adulthood trauma had a weaker association with late-life major depression in the presence of childhood physical abuse (SHR = 0.91, 95% CI = 0.85-0.98, P = .015). There was a significant dose-response relationship (SHR = 1.20, 95% CI = 1.16-1.24, P < .001).

Conclusions: Childhood adversities increase the risk of major depression in later life, particularly for those who experienced physical abuse and trouble with the police. Men may be more susceptible to the mental health detriments of childhood adversities.

Keywords: adverse childhood experience; competing-risks analysis; geriatric depression.