Objective-Previous research on the physical health consequences of childhood abuse and other adversities has been based on data from young or middle-aged adults. This study addressed the question of whether childhood abuse and other adversities have lasting, detectable consequences for inflammation and cell aging late in life, and whether the effects are large enough to be discernible beyond that of a major chronic stressor, dementia family caregiving.Method-In this community sample of 132 healthy older adults (mean age = 69.70, SD=10.14), including 58 dementia family caregivers and 74 noncaregivers, blood samples were analyzed for interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and telomere length, a measure of cell aging. Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale (CES-D).Results-After controlling for age, caregiving status, gender, body mass index, exercise, and sleep, the presence of multiple childhood adversities was related to both heightened IL-6 (.37 ± .03 vs. .44 ± .03 log10 pg/mL) and shorter telomeres (6.51 ± .17 vs. 5.87 ± .20 Kb), compared to the absence of adversity; the telomere difference could translate into a 7-15 year difference in lifespan. Abuse was associated with heightened IL-6 and TNF-α levels, and, for TNF-α, this relationship was magnified in caregivers compared to controls. Moreover, abuse and caregiving status were significantly and independently associated with higher levels of depressive symptoms.Conclusions-Adverse childhood events are related to continued vulnerability among older adults, enhancing the impact of chronic stressors. Childhood adversities cast a very long shadow. Keywordspsychoneuroimmunology; IL-6; TNF-α; depression; cell aging; trauma Adverse events during childhood have been associated with a higher prevalence of several mental disorders, including DSM-IV-defined mood disorders, disruptive behavior, and substance abuse disorders (1). In fact, simulation data suggested that adversities were associated with 44.6% of all childhood-onset disorders and 25.9% to 32% of adult-onset disorders (1). Adults who experienced abuse or neglect as children appear to have an enhanced emotional sensitivity to stress; they are more likely to develop psychiatric disorders when confronting subsequent stressors than adults who did not have a similarly troubled history (2). Indeed, childhood maltreatment is a particularly potent risk factor for depression in adults, especially when individuals encounter stressful life events (3).In addition to the enhanced emotional stress sensitivity associated with childhood adversity, heightened physiological stress sensitivity has also been documented (3). Alterations in hypothalamic-pituitary-adrenal (HPA) axis and autonomic stress responses have been found in adult survivors of childhood abuse compared to similar individuals without a history of abuse (4,5). Findings from trauma survivors consistent with neuroendocrine stress response sensitization include enhanced glucocorticoi...