title: The effect of lifetime cumulative adversity on change and chronicity in depressive symptoms and quality of life in older adults.
abstract: BACKGROUND
  Lifetime cumulative adversity (LCA) has a detrimental effect on mental health. However, it is less clear whether it also increases the risk for mental health deterioration across time, and whether it is related to a continuous impairment in mental health among older adults. The current study aimed to examine whether LCA is related to deterioration and to continuous vulnerability in depressive symptoms and quality of life.
  
  
  METHODS
  Nine thousand one hundred fifty four older adults (mean age = 63 at Wave 1) who participated in the first three waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) reported exposure to negative life events, depressive symptoms, and quality of life.
  
  
  RESULTS
  Respondents with more LCA were at greater risk of high level of depressive symptoms and low level of quality of life. Those with more adversity were at greater risk of reporting an increase in depressive symptoms and a decrease in quality of life between waves. LCA was also related to continuous high level of depressive symptoms and low level of quality of life. The effect of LCA was stronger for depressive symptoms than for quality of life.
  
  
  CONCLUSIONS
  LCA is associated with decline, as well as with continuous impairment, in major markers of mental health at the second half of life. The overall modest effects imply that resilience to LCA is widespread among older adults. Still, prevention and intervention programs should target old people with cumulative adversity, as they are in risk for deterioration and chronic vulnerability in important components of mental health.
authors.affiliation: Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel. amitshar@post.tau.ac.il
authors.forename: Amit
authors.initials: A
authors.lastname: Shrira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D018450:Disease Progression; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D011580:Psychological Techniques; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors