title: Risk and protective factors for depressive symptoms among American Indian older adults: adverse childhood experiences and social support.
abstract: OBJECTIVE
  Despite efforts to promote health equity, many American Indian and Alaska Native (AI/AN) populations, including older adults, experience elevated levels of depression. Although adverse childhood experiences (ACE) and social support are well-documented risk and protective factors for depression in the general population, little is known about AI/AN populations, especially older adults. The purpose of this study was to examine factors related to depression among a sample of AI older adults in the midwest.
  
  
  METHODS
  Data were collected using a self-administered survey completed by 233 AIs over the age of 50. The survey included standardized measures such as the Geriatric Depression Scale-Short Form, ACE Questionnaire, and the Multidimensional Scale of Perceived Social Support. Hierarchical multivariate regression analyses were conducted to evaluate the main hypotheses of the study.
  
  
  RESULTS
  Two dimensions of ACE (i.e., childhood neglect, household dysfunction) were positively associated with depressive symptoms; social support was negatively associated with depressive symptoms. Perceived health and living alone were also significant predictors.
  
  
  CONCLUSIONS
  ACE may play a significant role in depression among AI/AN across the life course and into old age. Social support offers a promising mechanism to bolster resilience among AI/AN older adults.
authors: a Department of Social Work , University of South Dakota , Sioux Falls , SD , USA.
authors: Soonhee
authors: S
authors: Roh
authors: Catherine E
authors: CE
authors: Burnette
authors: Kyoung Hag
authors: KH
authors: Lee
authors: Yeon-Shim
authors: YS
authors: Lee
authors: Scott D
authors: SD
authors: Easton
authors: Michael J
authors: MJ
authors: Lawler
mesh_terms: D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D065840:Protective Factors; D012044:Regression Analysis; D012307:Risk Factors; D012944:Social Support; D013023:South Dakota / Q000453:epidemiology
keywords: American Indian; Native Americans; adverse childhood experiences; older adults; risk and protective factors; social support