The impact of perceived caregiver anxiety and stress during childhood on late-life depression: evidence from the China Health and Retirement Longitudinal Study

Abstract

Introduction: This study investigates the long-term impact of perceived caregiver anxiety and stress during childhood on late-life depression. Adverse childhood experiences related to caregiver mental health may significantly influence emotional well-being, and this study utilizes data from the China Health and Retirement Longitudinal Study (CHARLS) to explore these associations.

Methods: CHARLS data were analyzed for individuals who reported perceived caregiver anxiety and stress. Depression was measured using the CES-10 depression scale. Multivariate logistic regression models examined the relationship between caregiver anxiety and stress frequency and late-life depression, adjusting for confounders like socioeconomic status, health behaviors, and demographics.

Results: Childhood exposure to caregiver anxiety and stress significantly increased the risk of depression in later life (p < 0.05), with stronger effects observed among individuals with female caregivers. The risk escalated with the frequency of caregiver anxiety episodes. After adjusting for covariates, the association for male caregivers weakened, highlighting the potential role of other mediators.

Discussion: The results highlight the critical importance of parental mental health, especially maternal anxiety, in mitigating intergenerational mental health risks. Targeted interventions for caregiver mental health, particularly for female caregivers, are crucial. Longitudinal studies are needed to better establish causality and further investigate these mechanisms.

Keywords: CHARLS; childhood adversity; intergenerational mental health; late-life depression; perceived caregiver anxiety; perceived caregiver stress.

Figure 1

The flowchart of inclusion and exclusion for the 2015 follow-up data.

Figure 2

The forest plot of subgroup analysis on guardian stress and anxiety in relation to children’s depression.

Figure 3

The forest plot of subgroup analysis on male guardian stress and anxiety in relation to children’s depression. This figure is a forest plot of the subgroup analysis on male guardian stress and anxiety in relation to the risk of children’s depression. It shows how different levels of female guardian stress and anxiety (“Some of the time,” “Good part of the time,” and “Most of the time”) affect the risk of depression in children. Each entry displays the Odds Ratio (OR) and its 95% confidence interval (CI) for various subgroups. Different shapes and colors represent the results for the three time periods: blue circles represent “Some of the time,” green squares represent “Good part of the time,” and red triangles represent “Most of the time.” • X-axis: Represents the OR (Odds Ratio), with the dashed line indicating OR = 1. If the 95% confidence interval of the OR does not include 1, it indicates that the factor has a statistically significant effect on the outcome. • p-value: The p-values for each time period are displayed in the blue, green, and red columns, indicating the statistical significance of maternal anxiety on children’s depression for each time period. • p for interaction: The purple column on the far right shows the p-value for interaction, which tests for significant differences between subgroups.

Figure 4

The forest plot of subgroup analysis female on guardian stress and anxiety in relation to children’s depression. This figure is a forest plot of the subgroup analysis on female guardian stress and anxiety in relation to the risk of children’s depression. It shows how different levels of female guardian stress and anxiety (“Some of the time,” “Good part of the time,” and “Most of the time”) affect the risk of depression in children. Each entry displays the Odds Ratio (OR) and its 95% confidence interval (CI) for various subgroups. Different shapes and colors represent the results for the three time periods: blue circles represent “Some of the time,” green squares represent “Good part of the time,” and red triangles represent “Most of the time.” • X-axis: Represents the OR (Odds Ratio), with the dashed line indicating OR = 1. If the 95% confidence interval of the OR does not include 1, it indicates that the factor has a statistically significant effect on the outcome. • p-value: The p-values for each time period are displayed in the blue, green, and red columns, indicating the statistical significance of maternal anxiety on children’s depression for each time period. • p for interaction: The purple column on the far right shows the p-value for interaction, which tests for significant differences between subgroups.