The association between life adversity and depression in older adult life

This in-depth investigation into the nature and prevalence of adversity within late life involved a two phased study, employing questionnaire and interview measures with a mixed methods analysis. The larger (n=960) PHQ-9 and LTE-Q study showed depression prevalence of 12% in older adults, who most commonly experienced adversity involving health and bereavement. Depressed participants reported significantly more recent adversity, a finding observed particularly in the early stages of older adult life and amongst women. Logistic regression showed adversity to be a significant predictor of depression, accounting for 1.8% of the variance in depression. The smaller (n=19) LEDS study showed a significant prevalence of low threat difficulties across the sample, who also reported health, relationships and bereavement to be the most commonly experienced. Depressed participants were shown to report higher rates of marked difficulties and lower social emotional support than non-depressed participants, which may play a key role in the maintenance of late-life depression. Although the LTE-Q was shown to be a crude measure, only capturing a portion of LEDS measured adversity, the general pattern of life event characteristics maps well onto the LEDS data. This was mirrored in the qualitative accounts of older adults who preferred the LEDS and considered it to capture adversity in depth. Thematic analysis revealed themes around ‘self-redefinition,’ ‘being immortal,’ and ‘leaving in peace’ were pertinent to both adversity and coping in late life, which were experienced differently by depressed participants as ‘powerless in the face of reality,’ ‘threats to immortality’ and ‘leaving in disharmony.’ Further investigations are required to determine how adversity contributes to depressive experience in the elderly, in particular examining the roles of marked difficulties and social emotional support. Suggestions are made for psychological interventions to consider the social contexts of older adults, while facilitating the coping processes highlighted in the qualitative analysis.