Adverse childhood experiences and late-life depression in Korea: The role of developmental timing and gender-specific vulnerability

Abstract

Background: This study examined the association between adverse childhood experiences (ACEs) and depressive symptoms among older adults in South Korea and explored variation by exposure timing and gender. Methods: We analyzed 10,067 older adults from the Korean Welfare Panel Survey. Depressive symptoms were measured via the 11-item Center for Epidemiologic Studies Depression scale. We assessed four ACEs: parental death, parental divorce, suspension of schooling due to financial strain, and being raised by relatives due to financial strain. Generalized estimating equations accounted for repeated measures, with exploratory stratified analyses by gender and exposure timing. Results: Any ACE exposure was associated with higher odds of later-life depressive symptoms (aOR = 1.25, 95% CI: 1.18-1.32), with a dose-response pattern (1 ACE: aOR = 1.20, 95% CI: 1.12-1.29; >= 2 ACEs: aOR = 1.38, 95% CI: 1.26-1.50). Among the four ACE indicators, parental death (aOR = 1.14, 95% CI: 1.07-1.22), school suspension (aOR = 1.18, 95% CI: 1.11-1.26), and being raised by relatives (aOR = 1.18, 95% CI: 1.03-1.35), were significantly associated with depressive symptoms. Parental divorce was associated with depressive symptoms among female when experienced during school-age (aOR = 2.61, 95% CI: 1.07-6.34) and adolescence (aOR = 2.04, 95% CI: 1.01-4.10). Among male, parental death during adolescence (aOR = 1.33, 95% CI: 1.09-1.62) and school suspension during school-age (aOR = 1.38, 95% CI: 1.16-1.63) were associated with depressive symptoms. Conclusions: ACEs showed long-term associations with significant depressive symptoms in later life. Exploratory findings by exposure timing and gender support life-course-informed and gender-sensitive approaches to prevention and mental health support in older adults.