Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat-Gan, Israel.
Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel.
J Gerontol B Psychol Sci Soc Sci. 2014 Nov;69(6):953-65. doi: 10.1093/geronb/gbu056. Epub 2014 Jun 4.
The study aimed to examine whether lifetime cumulative adversity (LCA) and depressive symptoms moderate time-related trajectories of functional status.
A total of 15,073 older adults (mean age = 63.91 at Wave 1) who participated in the first four waves of the Survey of Health, Ageing and Retirement in Europe reported on exposure to negative life events, depressive symptoms and three measures of functional status-difficulty in performing daily and instrumental activities, and functional limitation.
Growth-curve models showed that time-related increase in disability and functional limitation was steeper among those exposed to higher levels of lifetime adversity. Moreover, a three-way interaction between time, lifetime adversity, and depressive symptoms emerged across measures of functional status, so that when exposure to lifetime adversity was accompanied by high level of depressive symptoms, the time-related increase in disability and functional limitation was the steepest.
LCA is associated with a hastening of the disablement process, especially under conditions of high distress. Although the overall modest effects imply that resilience to lifetime adversity is widespread among older adults, prevention and intervention programs should consider that distressed older adults previously exposed to high levels of lifetime adversity are at risk for more rapid impairment in functional status.
本研究旨在探讨一生中累积的逆境（LCA）和抑郁症状是否会调节功能状态的时间相关轨迹。
共有 15073 名老年人（第 1 波时的平均年龄为 63.91 岁）参加了欧洲健康、老龄化和退休调查的前四波，报告了负面生活事件、抑郁症状和三项功能状态测量的暴露情况——日常和工具性活动的困难以及功能受限。
增长曲线模型显示，一生中遭受更多逆境的人，残疾和功能受限的时间相关性增加更为陡峭。此外，在功能状态的各项测量中出现了时间、一生中的逆境和抑郁症状之间的三向交互作用，因此，当一生中的逆境伴随着高水平的抑郁症状时，残疾和功能受限的时间相关性增加最为陡峭。
LCA 与残疾过程的加速有关，尤其是在高压力的情况下。尽管总体影响较小，但意味着对一生中逆境的适应能力在老年人群中广泛存在，但预防和干预计划应考虑到以前经历过高水平一生中逆境的痛苦老年人在功能状态方面受损更快的风险。
