Risk and protective factors for depressive symptoms among American Indian older adults: Adverse childhood experiences and social support

Abstract

Objectives: Despite efforts to promote health equity, many American Indian and Alaska Native (AI/AN) populations, including older adults, experience elevated levels of depression. Although adverse childhood experiences (ACE) and social support are well-documented risk and protective factors for depression in the general population, little is known about AI/AN populations, especially older adults. The purpose of this study was to examine factors related to depression among a sample of AI older adults in the midwest.

Method: Data were collected using a self-administered survey completed by 233 AIs over the age of 50. The survey included standardized measures such as the Geriatric Depression Scale-Short Form, ACE Questionnaire, and the Multidimensional Scale of Perceived Social Support. Hierarchical multivariate regression analyses were conducted to evaluate the main hypotheses of the study.

Results: Two dimensions of ACE (i.e., childhood neglect, household dysfunction) were positively associated with depressive symptoms; social support was negatively associated with depressive symptoms. Perceived health and living alone were also significant predictors.

Conclusion: ACE may play a significant role in depression among AI/AN across the life course and into old age. Social support offers a promising mechanism to bolster resilience among AI/AN older adults.

Keywords:

• adverse childhood experiences
• American Indian
• Native Americans
• older adults
• risk and protective factors
• social support

Acknowledgements

The lead author would like to acknowledge Dr. Robin Miskimins and Dr. Yuri Jang for their mentoring on a New Faculty Research grant for Dr. Roh. In addition, the lead author is grateful to Hyunwoo Yoon, MSW, for his helpful research assistance.

Additional information

Funding

The data used in the study were collected with support from the University of South Dakota Internal Grants for New Faculty Research and Creative Activity.