Influence of childhood abuse and neglect subtypes on late-life suicide risk beyond depression.

The association of childhood maltreatment and suicide has been extensively examined within the population. Depression figures as a main cause for the elevated suicide rate in advanced ages and is often related to childhood maltreatment. The purpose of the present study was to examine the relationship between childhood maltreatment subtypes and suicide risk, testing geriatric depression as a moderator. This is a cross-sectional study looking at a sample of 449 individuals 60 year s old or older from the Multidimensional Study of the Elderly of Porto Alegre Family Health Strategy, Brazil (EMI-SUS/POA). Childhood maltreatment (Childhood Trauma Questionnaire), geriatric depressive symptoms (Geriatric Depression Scale), and suicide risk (Mini International Neuropsychiatric Interview) were assessed. The subtypes of childhood abuse and neglect were significantly associated with suicide risk. In the multivariate analysis, controlling for age, gender, income, marital status, ethnicity, smoking, and geriatric depression symptoms, all trauma subtypes remained associated with suicide risk with the exception of physical neglect (EA = 3.65; PA = 3.16; SA = 5.1; EN = 2.43; PN = 1.76). The present study showed that childhood maltreatment subtypes predicted suicide risk, and geriatric depression does not directly mediate this relation

Relationship between childhood maltreatment and geriatric depression: the mediator effect of personality traits.

Childhood maltreatment is an important factor associated with adverse mental health outcomes including geriatric depression and the "big five" personality characteristics. The objective of this study was to evaluate a model where personality characteristics mediate the relationship between childhood maltreatment and geriatric depression. In this cross-sectional study, elderly subjects from socioeconomically disadvantaged neighborhoods of Porto Alegre, Brazil (n = 260) completed the Childhood Trauma Questionnaire (CTQ), NEO-Five Factor Inventory (NEO-FFI), and Mini International Neuropsychiatric Interview 5.0 (MINI plus). We used structural equation modeling (SEM) to evaluate the mediation hypothesis. The five personality factors (neuroticism, extraversion, agreeableness, openness, and conscientiousness) were related to childhood maltreatment and depression. Mediation analysis revealed that neuroticism and extraversion are complete mediators, agreeableness and conscientiousness are partial mediators, and openness is not a mediator. These findings support the hypothesis in which childhood maltreatment is associated with geriatric depression and mediated by personality factors. These results suggest that reducing the maladaptive personality trait in elderly people who suffered childhood maltreatment could prevent geriatric depression

Association between Big Five personality factors and medication adherence in the elderly.

Adherence to medications can be associated with circumstances related to the patient, with the pathology, with cultural health beliefs, with habits, and with quality of life. Behavioral patterns can also directly influence a patient's pharmacological adherence, since they are related to their perception and understanding of their own health status and of their drug and non-drug treatments. To investigate the association between adherence to pharmacological treatment and personality factors, sociodemographic variables, and economic data in the elderly. Cross-sectional descriptive study. The population studied were elderly people registered with the Family Health Strategy of Porto Alegre and enrolled on the Brain Aging Program (PENCE), from March 2013 to November 2015. Sociodemographic data, pharmacological adherence, and personality traits were evaluated. Exclusion criteria were incomplete data in the personality and pharmacological adherence assessments; cognitive impairment, evaluated using the instrument Mini-Mental State Examination (MMSE), or not having carried out this assessment. A total of 123 individuals were included with a mean age of 71.35±7.33 years, 58.6% of whom reported some level of non-adherence to their medication regime (low and moderate adherence). Elderly people with low adherence had significantly higher mean scores in the Neuroticism factor, while those with high adherence had significantly higher mean scores in the Agreeableness and Conscientiousness factors. The study suggests that pharmacological adherence among the elderly is negatively associated with the Neuroticism personality trait, while the Agreeableness and Conscientiousness traits are positively associated

Do Adult Attachment Style or Personality Mediate the Relationship Between Childhood Maltreatment and Late-Life Depression in Poor Communities?

Childhood maltreatment is associated with late-life depression. Preliminary evidence indicates that personality characteristics, in particular neuroticism and extroversion, and an anxious attachment style mediate this association. The objective is to evaluate 3 models, in which personality and attachment are considered mediators between childhood maltreatment and late-life depression in a socioeconomically disadvantaged Brazilian population. This study included participants (n = 260) from socioeconomically disadvantaged neighborhoods of Porto Alegre, Brazil, who completed measures of childhood maltreatment (Childhood Trauma Questionnaire - CTQ), personality characteristics (NEO-Five Factor Inventory), attachment styles (Relationship Scales Questionnaire), and geriatric depression (Mini-International Neuropsychiatric Interview-Plus). General multiple and sequential mediation analyses were used to test for possible associations. Attachment anxiety but not attachment avoidance is a mediator between childhood maltreatment and geriatric depression. Neuroticism is a full mediator. At that, attachment anxiety was found to be a predictor of neuroticism. Finally, sequential mediation analysis shows a path from childhood maltreatment to geriatric depression through attachment anxiety and neuroticism. The results suggest a pathway from childhood maltreatment to anxious attachment, which in turn predicts higher neuroticism that itself may favor late-life depression. This hypothesis could have implications for older adults living in low socioeconomic settings in that treating the high-risk group of maltreated children may help prevent late-life depression

The inverted CD4:CD8 ratio is associated with cytomegalovirus, poor cognitive and functional states in older adults

Background: Some premature features of immunosenescence have been associated with persistent viral infections and altered populations of T cells. In particular, the inverted T CD4:CD8 ratio has been correlated with increased morbidity and mortality across different age groups. Objective: Here, we investigated the role of persistent viral infections, cognitive and functional states as predictors of inverted CD4:CD8 ratio of older adults in a developing country. Methods: Three hundred and sixty community-dwelling older adults (aged 60-103 years) were recruited. Cognitive function was evaluated by the Instrument of Brief Neuropsychological Assessment and Mini-Mental State Examination inventory. Functional Activities Questionnaire was used to determine activities of daily living. Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) serologies were determined by ELISAs. Peripheral blood was assessed for lymphocyte subsets by flow cytometry (CD4+, CD8+, NK, NKT, B and CD8+CD28-). Results: Fifty-nine individuals were identified with CD4:CD8 ratio 1. The older adults with inverted CD4:CD8 ratio had impairments in some cognitive dimensions and had more functional disability and dependency (p = 0.01) than subjects with CD4:CD8 ratio >1. The lymphocyte subsets did not vary between groups. The increased CMV-IgG titers alone contributed to 8× higher chance to invert CD4:CD8 T cell ratio (OR 8.12, 95% CI 1.74-37.88, p < 0.01). Conclusion: Our data further indicate the role of CMV on circulating T cells, poor cognition and functional disability/dependency during aging