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The negative impact of adverse childhood experiences (ACEs) on mental health has been well documented. While most of the evidence comes from samples of adolescents and young adults, few studies have investigated whether ACEs contribute to poorer mental health among older adults. In particular, depressive symptoms are common in old age, and they display heterogeneous patterns of development across individuals. Therefore, it is important to examine if ACEs are predictive of distinct trajectories of depressive symptoms among older adults.
Objectives
Using longitudinal data from the English Longitudinal Study of Ageing (ELSA), we aimed to examine if ACEs could differentiate between distinct trajectories of depressive symptoms over eight years in community-dwelling older adults.
Methods
Participants from ELSA aged 60 or above who reported no psychiatric diagnoses and completed the items of ACEs at baseline (wave 3) were included in the current study. Nine items of ACEs were subject to a principal component analysis to identify the underlying subtypes. Data of depressive symptoms from waves 3 to 7 (2-year apart), assessed with the 8-item Centre for Epidemiological Studies Depression Scale, were extracted for modelling the distinct trajectories using latent class growth analysis. The trajectories were predicted by subtypes of ACEs using multinomial logistic regression, adjusting for childhood socioeconomic status, sex, age and ethnicity.
Results
The final sample consisted of 4057 participants (54.4% female, mean age= 71.34 (SD= 8.14)). We identified five trajectories of depressive symptoms (Figure 1): ‘low stable’ (73.4%), ‘increasing then decreasing’ (9.9%), ‘high decreasing’ (7.1%), ‘high stable’ (5.7%) and ‘moderate increasing’ (4.0%). Four subtypes of ACEs (i.e., sexual abuse, separation from natural parents, family dysfunction and physical assault) were evident. Compared to the ‘low stable’ group, higher levels of family dysfunction were reported in the ‘increasing then decreasing’ (aOR = 1.35, 95% CI [1.10 - 1.66], p = .012), ‘high stable’ (aOR = 1.59, 95% CI [1.30 - 1.96], p < .001) and ‘moderate increasing’ (aOR = 1.55, 95% CI [1.18 - 2.04], p = .011) groups. The ‘high stable’ group also reported a higher level of separation from natural parents than the ‘low stable’ group (aOR = 1.34, 95% CI [1.04 - 1.72], p = .047). Sexual abuse and physical assault did not predict any group differences.
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Conclusions
Distinct trajectories of depressive symptoms among older adults were predicted by family dysfunction in childhood. Our findings suggested that the negative impact of ACEs on mental health may extend beyond adolescence and young adulthood into the old age.
This concluding chapter brings all prior chapters together in offering considerations for diverse older adults and their service providers, including center managers, policy makers, adult and music educators, and activity leaders. The authors also draw implications for researchers in a wide range of fields and advocate for an interdisciplinary approach and cross-disciplinary collaborations in further studies in the field.
An insider’s view is presented of six senior centers serving culturally and socioeconomically diverse populations of senior citizens, in cities of different sizes and across different regions of the United States. Via vivid description and a first-person storytelling style, the authors describe each center’s physical layout, ambience or “vibe,” daily operations, clientele, support networks, and challenges. The following emergent commonalities across all six senior centers are discussed in detail: (1) accessibility, (2) active and welcoming, (3) extension of services, (4) resources, (5) variety and choice, and (6) wellness.
This chapter sets the stage for the book by providing an overview of the social, psychological, and physical benefits of music participation that enhance the overall well-being of older adults. The authors discuss various venues where musical activities for older adults might take place and then zoom in to portray senior centers across the United States, followed by an elucidation of the need for a series of studies on the musical engagement of older adults, a culturally undervalued population. A rationale is shared for examining how senior centers are adopting dramatic changes in their music activities through a global pandemic, leading into a new normal. Voices demanding changes in these centers segue into an introduction to the subsequent chapters of the book.
The dramatic impact of the global pandemic has reached every sector of society, and older adults are no exception. This chapter presents a mid-pandemic (October 2021) survey study of senior center managers in six cities of different sizes across the United States regarding the changes made in senior center activities since the pre-pandemic period (prior to March 2020), with a specific focus on musical activities in three categories: music-making, dance and exercise with music, and attending live music performance. Discussions also include how center managers plan to adopt changes in their programs and services, especially in musical offerings, as we emerge from the pandemic.
The authors home in further in this chapter to examine how music played a part in the lives of older adult clients of six senior centers. Interviewees’ colorful words and stories combine with the authors’ recollections of their visits to weave a figurative tapestry of senior center clients’ musical histories and music participation, both within and outside senior centers. A brief foray is also made into the musical backgrounds of center activity leaders. All of this information sets the stage for an exploration of these adults’ motivations for engaging in music and the barriers some encountered along the way. The chapter ends with a brief synthesis of the role of music participation in interviewees’ quality of life.
In the final chapter of Part II, the authors take a broad view of the sights, sounds, and stories shared in Chapters 3–5, point out findings that support earlier research, and introduce and discuss new findings that emerged from this research journey. Conclusions are organized in three large sections that mirror the foci of the previous three chapters: the six senior centers, music within the centers, and perspectives on older adult center clients’ music participation. The chapter closes with new thoughts and ideas relative to the role of music in senior centers and in older adults’ lives.