title: Adverse childhood experiences and geriatric depression: results from the 2010 BRFSS.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AK.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Ege
authors.affiliation: Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AK. Electronic address: emessias@gmail.com.
authors.forename: Erick
authors.initials: E
authors.lastname: Messias
authors.affiliation: Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AK; Arkansas State Hospital, Little Rock, AK.
authors.forename: Purushottam B
authors.initials: PB
authors.lastname: Thapa
authors.affiliation: Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AK.
authors.forename: Lewis P
authors.initials: LP
authors.lastname: Krain
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014481:United States / Q000453:epidemiology
keywords: Adverse childhood experiences; epidemiology; late life depression