Gender, racial, ethnic and cognitive status disparities in ACEs, depression, and life satisfaction among US older adults.

OBJECTIVES: Adverse childhood experiences (ACEs) have been linked to depression and lower life satisfaction. Few studies have examined depression as a mediator between ACEs and life satisfaction or potential disparities. The aims of this study were to examine the mediating role of late-life depression between ACEs and life satisfaction and examine disparities by race, ethnicity, gender and cognitive status.

METHOD: Data were obtained from the 2012-2020 Health and Retirement Study ( = 3,924). Interaction terms were used to test for moderation by gender (Male, Female), race (Black, White, Other), ethnicity (Hispanic, non-Hispanic), and cognitive status (normal; cognitively impaired, no dementia (CIND); living with dementia). Mediation analysis was used to determine the direct and indirect effects among ACEs, depression, and life satisfaction overall and by demographic/cognitive subgroups.

RESULTS: Depression mediated the association between ACEs and life satisfaction in the overall study population (B=-0.047,  < 0.001). Interactions terms were not statistically significant. However, stratified models showed an indirect effect of ACEs on life satisfaction through depression for men, women, Black, White, Hispanic, non-Hispanic populations, and individuals with normal cognition, CIND, and dementia.

CONCLUSION: Alleviating depression may improve life satisfaction across gender, race/ethnicity, and cognitive status. Addressing ACEs may also improve depression and life satisfaction.