Violence across the life course and physical and mental health trajectories in later life: a 13-year population-based cohort study in England

Evidence shows that violence in childhood affects health in adulthood, and violence in adulthood is associated with worse health. However, the extent to which violence-related health disparities persist into later life and whether the gap between victims and non-victims narrows, remains stable, or widens over time are unclear. This study aimed to examine the long-term effects of childhood and lifetime violence on health trajectories in older age. The English Longitudinal Study of Ageing is one of the only cohort studies to cover violence across the lifespan alongside health trajectories in later life. Data were collected every 2 years between 2006 and 2019 and experiences of violence and limiting long-standing illness or disability (LLSID) were self-reported. We used logistic multilevel regressions and growth curve modelling to examine associations between parental physical abuse in childhood, lifetime physical or sexual violence, and any violence across the life course, with subsequent change in LLSID and depressive symptoms in later life, adjusted for demographic (age, gender, marital status, and region), socioeconomic (education, occupational class, tenure, and financial hardship), and social (household size and caregiving) attributes. Depressive symptoms were measured with the Centre for Epidemiological Studies Depression scale. Of the 9771 participants who responded to the questionnaire, 6171 answered all three questions about experiences of violence and were included in this cohort. Any experience of violence was consistently associated with worse health in older age, including depression scale score of at least 4 (men: adjusted odds ratio 1·99, 95% CI 1·34-2·94; women: 1·38, 1·02-1·86) and LLSID (men: 1·74, 1·08-2·81; women: 2·15, 1·45-3·17). The patterns were evident in men and women. Physical and mental health disadvantages associated with experiencing violence in childhood and adulthood are sustained throughout later life. There was little evidence that health disparities between victims and non-victims reduce over time. Preventing violence in both childhood and adulthood could promote healthy ageing. UK Prevention Research Partnership.