Gender, racial, ethnic and cognitive status disparities in ACEs, depression, and life satisfaction among US older adults.

OBJECTIVES

Adverse childhood experiences (ACEs) have been linked to depression and lower life satisfaction. Few studies have examined depression as a mediator between ACEs and life satisfaction or potential disparities. The aims of this study were to examine the mediating role of late-life depression between ACEs and life satisfaction and examine disparities by race, ethnicity, gender and cognitive status.

METHOD: Data were obtained from the 2012-2020 Health and Retirement Study (N = 3,924). Interaction terms were used to test for moderation by gender (Male, Female), race (Black, White, Other), ethnicity (Hispanic, non-Hispanic), and cognitive status (normal; cognitively impaired, no dementia (CIND); living with dementia). Mediation analysis was used to determine the direct and indirect effects among ACEs, depression, and life satisfaction overall and by demographic/cognitive subgroups.

RESULTS

Depression mediated the association between ACEs and life satisfaction in the overall study population (B=-0.047, p < 0.001). Interactions terms were not statistically significant. However, stratified models showed an indirect effect of ACEs on life satisfaction through depression for men, women, Black, White, Hispanic, non-Hispanic populations, and individuals with normal cognition, CIND, and dementia.

CONCLUSION

Alleviating depression may improve life satisfaction across gender, race/ethnicity, and cognitive status. Addressing ACEs may also improve depression and life satisfaction.