Traumatic stress and geriatric mental health specialist Dr. Joan Cook recently did an interview where she talked about how trauma affects older adults. A summary has been produced below and the full interview can be found here.
There are certain methodological considerations that have to be made when trying to study trauma and trauma-related symptoms in older populations. There is a greater tendency for people over age 65 to minimize their reporting or to engage in more denial-like behavior. This is due to a few different factors, but one is that the PTSD diagnoses was only introduced in 1980. This means that anyone who grew up prior to that period would have stronger associations of stigma or self-blame related to traumatic experiences and symptoms.
Applicability of Findings
Most PTSD studies that use older populations have targeted veterans. Dr. Cook was asked how valid findings about veterans are when applied to other groups of older adults. While Dr. Cook acknowledged the larger volume of research concerning veterans, she also pointed out that there is a decent pool of research concerning non-veterans as well. This includes those who suffered “Holocaust-related trauma” or went through natural or man-made disasters. The biggest gaps in trauma-related research exist in studying aging among racial/ethnic minorities, and on physical and sexual abuse in older men and women. Generalization is possible from other areas of PTSD research, but it should be done carefully. It’s always better to look into the nuances of specific variables when possible.
Dementia and PTSD
When asked about potential connections between dementia and PTSD, Dr. Cook admitted that there are more unknowns than knowns in this area. While adults with PTSD are known to perform poorly on cognitive tests, this sort of quality-of-life finding does not automatically lead to a clinical diagnosis of dementia. Case reports and studies have suggested that having PTSD makes someone twice as likely to develop dementia, while other research implies dementia may exacerbate existing PTSD symptoms. It is also possible that there is a third variable affecting both PTSD and dementia together.
Dr. Cook identified what she felt were some key priorities for researchers to focus on when studying PTSD in older adults over the coming years:
- Using larger sample sizes when testing PTSD treatments for older adults
- Probing the experiences of trauma and any trauma-related symptoms among the potentially most vulnerable older adults (long term care residents, the homebound, and those with physical/emotional/cognitive impairment)
- Looking into trauma-related depression in older adults
- Better fine-grain analysis of age groups, with studies dividing older adults into young-old (65–74 years), middle-old (75–84 years), and old-old (85+) rather than lumping them all under a generic older adult group
Jain, S., “The Golden Years: Traumatic Stress and Aging – An Interview with Joan Cook,” Mind the Brain web site, October 6, 2016; http://blogs.plos.org/mindthebrain/2016/10/06/the-golden-years-traumatic-stress-and-aging-an-interview-with-joan-cook/, last accessed October 11, 2016.