Lifetime Adversity Prospectively Predicts Depression, Anxiety, and
Cognitive Impairment in a Nationally Representative Sample of Older
Adults in the United States
Abstract
Objective: Although life stress and adversity have emerged as
risk factors for mental health problems and cognitive impairment among
older adults, prior studies on this topic have been cross-sectional and
based on relatively homogeneous samples. To address these issues, we
examined prospective associations between lifetime adversity and
symptoms of depression, anxiety, and cognitive impairment in a
nationally representative, longitudinal sample of older adults in the
U.S. Method: We analyzed data from the Health and Retirement
Study (1992-2016). The sample included 3,496 individuals (59.9%
female), aged ≥64 years old (M age=76.0 ±7.6 years). 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. Results: Many participants experienced a
significant early life (38%) or adulthood (79%) stressor. Second,
experiencing a childhood adversity was associated with a 17.4%
increased risk of experiencing an adulthood adversity. Finally,
childhood and adulthood adversities both prospectively predicted more
symptoms of late-life depression, anxiety, and cognitive impairment.
Discussion: These findings are among the first to demonstrate
prospective associations between lifetime adversity and symptoms of
depression, anxiety, and cognitive impairment in older adults. Screening
for lifetime stressors may thus help health care professionals and
policymakers identify individuals who could benefit from interventions
designed to reduce stress and enhance resilience.