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Contributors:
  1. Martina von Arx
  2. Stefan Sieber
  3. Maura Iversen

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Description: Adverse childhood experiences, depression, and functional dependence are inter-related. However, mechanisms underlying this relation remain unclear. Here, we investigated the potential of depression to mediate the effect of adverse childhood experiences on functional dependence in older age and whether physical activity moderated this mediation. Data from 25,775 adults aged 62±9 years from the Survey of Health Ageing and Retirement in Europe (SHARE) was used in adjusted linear mixed-effect models to test whether depression mediated the associations between adverse childhood experiences and functional dependence in activities of daily living (ADL) and instrumental activities of daily living (IADL) and whether physical activity moderated these mediations. As expected, adverse childhood experiences were positively associated with ADL (b = .040 for 0 vs. 1 and b = .067 for 0 vs. ≥2 adverse childhood experiences) and IADL (b = .046 for 0 vs. 1 and b = .076 for 0 vs. ≥2 adverse childhood experiences). Both associations were mediated by depression. Physical activity reduced the effect of adverse childhood experiences on depression (b = -.060 for 0 vs. 1 and b = -.135 for 0 vs. ≥2 adverse childhood experiences) and canceled the effect of depression on functional dependence in ADL (b = .073) and IADL (b = .100), thereby eliminating the effect of adverse childhood experiences on functional dependence. Physical activity cancels the impact of adverse childhood experiences on functional dependence. In inactive individuals, the effect of adverse childhood experiences on functional dependence (ADL and IADL) is mediated by depression.

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