title: The effect of lifetime cumulative adversity and depressive symptoms on functional status.
abstract: OBJECTIVE
  The study aimed to examine whether lifetime cumulative adversity (LCA) and depressive symptoms moderate time-related trajectories of functional status.
  
  
  METHODS
  A total of 15,073 older adults (mean age = 63.91 at Wave 1) who participated in the first four waves of the Survey of Health, Ageing and Retirement in Europe reported on exposure to negative life events, depressive symptoms and three measures of functional status-difficulty in performing daily and instrumental activities, and functional limitation.
  
  
  RESULTS
  Growth-curve models showed that time-related increase in disability and functional limitation was steeper among those exposed to higher levels of lifetime adversity. Moreover, a three-way interaction between time, lifetime adversity, and depressive symptoms emerged across measures of functional status, so that when exposure to lifetime adversity was accompanied by high level of depressive symptoms, the time-related increase in disability and functional limitation was the steepest.
  
  
  CONCLUSIONS
  LCA is associated with a hastening of the disablement process, especially under conditions of high distress. Although the overall modest effects imply that resilience to lifetime adversity is widespread among older adults, prevention and intervention programs should consider that distressed older adults previously exposed to high levels of lifetime adversity are at risk for more rapid impairment in functional status.
authors.affiliation: Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat-Gan, Israel. amit.shrira@biu.ac.il.
authors.forename: Amit
authors.initials: A
authors.lastname: Shrira
authors.affiliation: Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel.
authors.forename: Howard
authors.initials: H
authors.lastname: Litwin
mesh_terms: D000367:Age Factors; D000368:Aged; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013997:Time Factors
keywords: Difficult life events; Functional impairment; Mental health; SHARE.