Context matters: Longitudinal associations between childhood adversity and mental health outcomes of middle-aged and older adults in 26 countries during the COVID-19 pandemic

Background: Understanding the long-term impact of childhood adversity on mental health is crucial, particularly during public health crises like the COVID-19 pandemic. Emerging evidence highlights that contextual factors, such as the pandemic, interact with early-life experiences to influence mental health outcomes. However, little is known about how childhood adversity affected mental health across different phases of the pandemic among older adults. Methods: We used longitudinal data of 40,466 adults aged 50 years and older in 25 European countries and Israel from the Survey of Health, Ageing and Retirement in Europe (SHARE). Data were collected during the early (May to September 2020) and middle (June to August 2021) phases of the pandemic. Generalized linear mixed models (GLMM) were used to examine associations between childhood adversity and these outcomes, with additional analyses exploring moderating effects of COVID-19-related adversity (anyone close died from COVID, forwent medical care, etc.), stringent COVID-19 measures, living alone, and age. Results: Of the 40,466 participants (mean [SD] age, 69.66 [8.93] years; 58.74 % female), childhood adversity was significantly associated with adverse mental health during the pandemic. The associations exhibited a dose-response pattern, with stronger effects as the number of childhood adversities increased. Protective effects included low COVID-19-related adversity reducing trouble sleeping, living alone moderating depression and loneliness, and older age lessening anxiety and sleep issues at high adversity levels. Conclusions: Findings imply the need for targeted mental health interventions for older adults with early-life adversities to mitigate their vulnerability during public health crises like the COVID-19 pandemic.