The impact of life events on later life: A latent class analysis of the English longitudinal study of ageing

Objectives: Inequalities in life events can lead to inequalities in older age. This research aimed to explore associations between life events reported by older people and quality of life (QoL) and functional ability. Study Design: A latent class analysis (LCA) of the English Longitudinal Study of Ageing wave 3. Methods: Participants were grouped according to eight life events: parental closeness, educational opportunities in childhood, financial hardship, loss of an unborn child, bereavement due to war, involvement in conflict, violence, and experiencing a natural disaster. Linear and logistic regression were used to explore associations between these groups and the main outcomes of functional ability and QoL. Results: 7,555 participants were allocated to four LCA groups: “Few life events” (n=6,250), “Emotionally cold mother” (n=724), “Violence in combat” (n=274) and “Many life events” (n=307). Reduced QoL was reported in the “many life events” (coefficient -5.33, 95%CI -6.61 to -4.05), “emotionally cold mother” (-1.89, -2.62 to 1.15) and “violence in combat” (-1.95, -3.08 to -0.82) groups, compared to the “few life events” group. The “many life events” group also reported more difficulty with activities of daily living. Conclusions: Policies aimed at reducing inequalities in older age should consider events across the life course

Cross-Sectional and Longitudinal Associations of Chronic Posttraumatic Stress Disorder With Inflammatory and Endothelial Function Markers in Women

BackgroundPosttraumatic stress disorder (PTSD) may contribute to heightened cardiovascular disease risk by promoting a proinflammatory state and impaired endothelial function. Previous research has demonstrated associations of PTSD with inflammatory and endothelial function biomarkers, but most work has been cross-sectional and does not separate the effects of trauma exposure from those of PTSD.MethodsWe investigated associations of trauma exposure and chronic PTSD with biomarkers of inflammation (C-reactive protein and tumor necrosis factor alpha receptor II) and endothelial function (intercellular adhesion molecule-1 and vascular cell adhesion molecule-1) in 524 middle-aged women in the Nurses' Health Study II. Using linear mixed models, we examined associations of trauma/PTSD status with biomarkers measured twice, 10 to 16 years apart, in cardiovascular disease-free women, considering either average levels over time (cross-sectional) or change in levels over time (longitudinal). Biomarker levels were log-transformed. Trauma/PTSD status (based on structured diagnostic interviews) was defined as no trauma at either blood draw (n = 175), trauma at blood draw 1 but no PTSD at either draw (n = 175), and PTSD that persisted beyond blood draw 1 (chronic PTSD; n = 174). The reference group was women without trauma.ResultsIn models adjusted for known potential confounders, women with chronic PTSD had higher average C-reactive protein (B = 0.27, p < .05), tumor necrosis factor alpha receptor II (B = 0.07, p < .01), and intercellular adhesion molecule-1 (B = 0.04, p < .05) levels. Women with trauma but without PTSD had higher average tumor necrosis factor alpha receptor II levels (B = 0.05, p < .05). In addition, women with chronic PTSD had a greater increase in vascular cell adhesion molecule-1 over time (B = 0.003, p < .05).ConclusionsIncreased inflammation and impaired endothelial function may be pathways by which chronic PTSD increases cardiovascular disease risk