title: Life adversity in depressed and non-depressed older adults: A cross-sectional comparison of the brief LTE-Q questionnaire and life events and difficulties interview as part of the CASPER study.
abstract: BACKGROUND
  There is a paucity of research on the nature of life adversity in depressed and non-depressed older adults. Early life events work used in-depth interviews; however, larger epidemiological trials investigate life adversity using brief questionnaires. This study investigates the type of life adversity experienced in later life and its association with depression and compares adversity captured using a brief (LTE-Q) and in-depth (LEDS) measure.
  
  
  METHODS
  960 participants over 65 years were recruited in UK primary care to complete the PHQ-9 and LTE-Q. A sub-sample (n=19) completed the LEDS and a question exploring the subjective experience of the LTE-Q and LEDS.
  
  
  RESULTS
  Important life adversity was reported on the LTE-Q in 48% of the sample. In the LTE-Q sample the prevalence of depression (PHQ-9≥10) was 12%. Exposure to recent adversity was associated with doubling of the odds of depression. The LTE-Q only captured a proportion of adversity measured by the LEDS (42% vs 84%). Both measures showed health, bereavement and relationship events were most common.
  
  
  CONCLUSIONS
  The cross-sectional design limits the extent to which inferences can be drawn around the direction of causality between adversity and depression. Recall in older adults is questionable.
  
  
  CONCLUSIONS
  UK older adults face adversity in areas of health, bereavement and relationships which are associated with depression. This has clinical relevance for psychological interventions for older adults to consider social context and social support. It helps identify the strengths and weaknesses of a brief adversity measure in large scale research. Further research is needed to explore the mechanisms of onset and direction of causality.
authors.affiliation: Leeds Institute of Health Sciences, Academic Unit of Psychiatry & Behavioural Sciences, University of Leeds, UK.
authors.forename: Hjördis M
authors.initials: HM
authors.lastname: Donoghue
authors.affiliation: Leeds Institute of Health Sciences, Academic Unit of Psychiatry & Behavioural Sciences, University of Leeds, UK. Electronic address: G.Traviss@leeds.ac.uk.
authors.forename: Gemma D
authors.initials: GD
authors.lastname: Traviss-Turner
authors.affiliation: Leeds Institute of Health Sciences, Academic Unit of Psychiatry & Behavioural Sciences, University of Leeds, UK.
authors.forename: Allan O
authors.initials: AO
authors.lastname: House
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Lewis
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Gilbody
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D015995:Prevalence; D011320:Primary Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: Adversity; Depression; Life events; Older adults