Examining the Impact of Adverse Childhood Experiences on Multidimensional Well-Being Among Older Adults during Covid-19: The Mediating Role of Social Relationships

Background

While existing studies have highlighted the detrimental effects of adverse childhood experiences (ACEs) on well-being in later life, the underlying mechanisms implicated remain unclear. Especially during the Covid-19 pandemic, older adults have undergone significant changes in their social relationships due to the implementation of social distancing policies. However, the extent of their impact on the multidimensional well-being of older adults remains largely uncertain, particularly among those with ACEs.

This study has two aims. Firstly, we aim to identify the relationship between ACEs and multidimensional well-being, including physical, mental, and cognitive functions. Secondly, we seek to investigate the social relationship as a potential mediator in the association between ACEs and multidimensional well-being among older adults. To the best of our knowledge, this study represents the first investigation to explore the mechanism of how ACEs impact the multidimensional well-being of older adults, particularly in the context of the Covid-19 pandemic.

Method

Data were drawn from the Health and Retirement Study (HRS). The sample was selected from the respondents who were aged 65 or older in 2012 and had responded to both the 2012 and 2020 psychological question modules. (n=2,279). We analyzed the core variables of HRS in 2020, merging them with the adverse childhood traumatic experience variables from HRS in 2012 due to the availability of variables. Structural Equation Modeling (SEM) was used to examine the mechanism of the association between ACEs and multidimensional well-being. Drawing from stress process theory, five key variables were included in the model along with socio-demographic covariates. ACEs were measured with experiences such as school retakes, alcohol/drug abuse, and trouble with police before age 18 (0-4). The social relationship was measured with negative social support from close relationships during Covid-19. Physical health was assessed with self-rated health (1-5), while mental health was measured with the CES-D Depression symptoms index score (0-8). Cognitive functioning was assessed using the Telephone Interview for Cognitive Status (TICS) (0-35).

Result

Our results showed that ACEs were positively associated with depression symptoms (b=0.27, p<0.01). This underscores the enduring impact of early-life stressors on mental health outcomes in later life. We also found the mediating effect of negative social support on the association between ACEs and poor physical health (b=0.28, p<0.001), increased depression (b=0.83, p<0.001), and cognitive impairment (b=-0.34, p<0.001). This suggests that negative social interactions exacerbate the detrimental effects of ACEs on multidimensional well-being among older adults.

Discussion

Our findings highlight the interplay among childhood adversity, social relationships, and well-being in later life. Enhancing social relationships and integrating mental health screening in primary care may alleviate the effects of childhood trauma on later-life well-being among older adults with ACEs. Overall, our findings underscore the importance of comprehensive support strategies and integrated healthcare approaches to address the long-term impact of childhood trauma on the well-being of older adults, particularly in the context of the Covid-19 pandemic.