Brief Report
Adverse Childhood Experiences and Geriatric Depression: Results from the 2010 BRFSS

https://doi.org/10.1016/j.jagp.2014.08.014Get rights and content

Objective

Adverse childhood experiences (ACEs), including physical, sexual, and emotional abuse, have been shown to result in a variety of poor outcomes including depression. The majority of research has examined the impact of such events on adolescents and young adults leaving a dearth of information regarding how these events may affect depressive symptom point prevalence later in life.

Methods

Data from the U.S. CDC's 2010 Behavioral Risk Factor Surveillance Survey (BRFSS) were used to estimate the point prevalence of depression in individuals 60 years of age and greater based on presence or absence of certain ACEs. Depressive symptoms were assessed using eight items from the Patient Health Questionnaire (PHQ). Subjects with a PHQ score of 10 or greater were categorized as depressed. Six different types of ACE were included in the study: parents being physically abusive to each other, being physically harmed by a parent, being sworn at by the parent, being touched sexually by an adult, being forced to sexually touch an adult, and being forced into a sexual encounter. ACEs were categorized as never, single if subject reported it occurring once, or repeated if subject reported multiple episodes.

Results

The study sample consisted of 8,051 adults aged 60 years and greater who responded to questions about adverse childhood experiences. The study sample comprised 53% women, 83% Caucasian patients, and had a mean age of 70.4 years. After controlling for age, sex, and race, depression was significantly correlated with repeated ACEs of all types (adjusted odds ratio [AOR] ranging from 2.41 to 9.78, all statistically significant). The only ACE where a single occurrence was significantly associated with late-life depression was forced sexual intercourse (AOR: 2.92, 95% CI: 1.06–8.02). After controlling for all types of abuse in a single model, repeated physical abuse and repeated forced sexual intercourse remained significant (AOR: 2.94, 95% CI: 1.68–5.13; AOR: 3.66, 95% CI: 1.01–13.2, respectively).

Discussion

These results indicate a significant association between repeated ACEs and depression in older adults. When controlling for all forms of abuse, repeated physical abuse and forced sexual intercourse are significantly correlated with late-life depression. They emphasize the need to continue developing techniques to help individuals with a history of ACEs in order to decrease their negative effects, not only immediately, but also later in life.

Section snippets

Sample

This study utilizes data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS), available at the U.S. Centers for Disease Control and Prevention (CDC) website. The BRFSS consists of a randomly selected, nationally representative group of participants interviewed via telephone. The surveys consist of three main types: a fixed core of questions asked of all participants, optional modules that states may add if desired, and state-added questions. Complete information about the survey

Results

Our sample comprised 8,051 individuals aged 60 years and older who completed questions regarding depression and ACEs. Their demographics are represented in Table 1. As noted in the table, there are significant differences between the depressed and nondepressed groups in terms of race and number of ACEs, with no differences on sex or age.

Table 2 notes the point prevalence of depression, the crude odds ratio, and the odds ratio adjusted for sex, age, and race. Both prior to and after controlling

Discussion

In a large community sample of subjects 60 years or older, we found that depression point prevalence is significantly higher among those reporting repeated ACEs of any type. Overall, a onetime ACE is not significantly related to an increased point prevalence of depression in older adults, the one exception being forced sex, where one occurrence is enough to increase the point prevalence of depression. When all ACEs are included in one single model, significance is noted only for repeated acts

References (10)

There are more references available in the full text version of this article.

Cited by (95)

  • A national study of the influence of adverse childhood experiences on depression among Black adults in the United States

    2022, Journal of Affective Disorders
    Citation Excerpt :

    Logistic regression was used to examine associations between PY-MDE and 1) ACEs individually, 2) ACEs simultaneously, 3) any child abuse/neglect or any household dysfunction, and 4) cumulative ACEs. Nine ACEs were statistically significant at the bivariate level and were tested simultaneously to determine the impact of each ACE on depression when accounting for other ACEs as consistent with other studies (Ege et al., 2015; Gottschall et al., 2022). The prevalence of PY-MDE was used to determine the sample size for testing 9 ACEs simultaneously and a calculation of 10(9 ACEs)/0.10 for women and 0.042 for men, yielding a required sample of 900 for Black women and 2142 for Black men.

View all citing articles on Scopus
View full text