Child abuse survivors are almost two and a half times as likely to have poor mental health outcomes and four times more likely to be unhappy even in much later life, according to new research from UNSW.

And in a surprise finding that requires further research, the work also reveals that child abuse survivors are more likely to have achieved a tertiary education.

The study – the largest of its kind into the long-term effects of physical and sexual abuse – assessed 21,000 participants aged over 60 from five Australian states. The results have been published in the Journal of the American Geriatrics Society.

Poor physical health is another outcome, the study has found. Childhood physical and sexual abuse increases the risk of having three or more medical diseases, including cardiovascular events in women.

Behavioural health effects include suicidal behaviour, increased likelihood of smoking, substance abuse, and physical inactivity.

The news is not good in terms of social indicators, either. The research shows a higher prevalence of broken relationships, lower rates of marriage in late life, lower levels of social support, and a slightly increased likelihood of living alone.

“We found that the number of people reporting childhood abuse declined in older groups,” said the lead author, Associate Professor Brian Draper from UNSW’s School of Psychiatry. “This could mean that those who were the victim of childhood abuse are at increased risk of early death. It is also possible that childhood abuse was less prevalent in the older cohorts.”

“The effects of childhood abuse appear to last a lifetime, although maturation through life experience may ameliorate its effects in some individuals who are more resilient and cope better under stress,” the authors concluded.

The co-authors on the paper are Jon Pfaff, Nicola Lautenschlager and Osvaldo Almeida (University of Western Australia); Jane Pirkis (University of Melbourne); John Snowdon (University of Sydney) and Ian Wilson (University of Western Sydney).