Subjective age, PTSD and physical health among war veterans

War-Related Life Course Stress and Late-Life Subjective Age in Northern Vietnam

Background and Objectives

The role of early life stressors in subjective aging is weakly understood, especially in low- to middle-income countries. This paper investigated how early life stressors encountered in armed conflict influence subjective age among Vietnamese older adults who experienced war over decades of their early life.

Research Design and Methods

We analyzed survey data from the 2018 Vietnam Health and Aging Study involving 2,447 Vietnamese older adults who encountered diverse war-related stressors in early adulthood. The analytical sample (N = 2,341) included 50.9% women and 49.1% men, with an average age of 69.8. 41.1% are military veterans. We conducted survey-adjusted multinomial logistic regression analyses with mediation to predict the probability of feeling younger or older than one's chronological age. We examined how childhood adversity (i.e., childhood hunger and low parental SES) and wartime stressors (i.e., war-related violence, malevolent environment, and military service) influenced late-life subjective age, both directly and as mediated by late-life mental, functional, and physical health.

Results

We found significant associations between early adulthood war-related stressors and subjective age. Formal military service significantly lessened the relative risk of feeling subjectively old, and more plentiful wartime violence exposures significantly increased the risk of feeling younger than one's chronological age. Violence exposure's effects were both direct and indirect through functional and mental health. Conversely, greater exposure to wartime malevolent conditions (e.g., shortages of clean water and evacuations) and multiple episodes of severe hunger in childhood increased the risk of feeling older, effects both direct and mediated by late-life functional and mental health.

Discussion and Implications

Results suggest wartime stressors, especially war's malevolent environments and severe childhood hunger, experienced in many conflict-affected populations globally, have the potential to subjectively "age" survivors. Yet, not all war exposures are equal, and some may yield psychological and socioeconomic resources that support healthy aging.

The experience of aging before one's time during the coronavirus pandemic among war veterans in Israel

Subjective age, the personal sense of how old one feels, is an important concomitant of posttraumatic outcomes in the second half of life. The present study aims to disentangle the interrelationships between posttraumatic stress disorder symptoms (PTSS) and subjective age, during the COVID-19 pandemic, among a sample of Israeli older adults who are veterans of the 1973 Yom Kippur War. Participants were interviewed in 2015 (T1; N = 259; mean age = 65.23, SD = 5.32) and in 2020, during the COVID-19 outbreak in Israel (T2). We assessed subjective age, PTSS, fear of COVID-19, self-rated health, and COVID-19 related accelerated subjective aging. A cross-lagged path analysis showed that while higher PTSS at T1 were associated with an increase in subjective age from T1 to T2, subjective age at T1 was not associated with PTSS at T2. PTSS at T1, but not subjective age, were associated with higher COVID-19 related accelerated subjective aging at T2. Older adults with continued PTSS due to past traumas, might be susceptible to the stressors of COVID-19 expressed in the personal subjective experience of having aged quickly in a short period of time. Our findings also suggest that in the context of stress and trauma, subjective age is more appropriately conceived as an outcome variable rather than a predictor of PTSS.

Aging together in the aftermath of war: marital adjustment and subjective age of veterans and their spouses

OBJECTIVES

Trauma has long-term effects on those directly exposed to it, but it also impacts those closest to them, particularly one's spouse, as the marital relationship is of central importance for late-life development. Furthermore, traumatic experiences have been shown to be involved in an acceleration of aging, whether through physical health, or via psychological pathways, through an older subjective age. The present work seeks to examine the mutual connections between marital adjustment and the psychological accelerated aging of both spouses among military veterans of the Israeli 1973 Yom Kippur War.

METHOD

Data from two assessments were drawn from a larger longitudinal study. In 2008 (T1) and again in 2015 (T2), 247 veterans and their wives were interviewed on their subjective age, marital adjustment, and PTSD symptoms.

RESULTS

An actor-partner interdependence model combined with an autoregressive cross-lagged model, controlling for T1 PTSD symptoms revealed that men's subjective age at T1 was associated with women's subjective age at T2, and women's subjective age at T1 was associated with men's subjective age at T2. Women's marital adjustment at T1 was associated with men's marital adjustment at T2 but not the other way around.

CONCLUSION

Spousal relationships are an important arena in the lives of older adult veterans. The present study contributes new knowledge regarding the paths that predict subjective age by taking account of the subjective age of one's spouse, as well as levels of marital adjustment. Insights regarding secondary traumatization, as well as gender differences, for the aging process are discussed.

Subjective accelerated aging moderates the association between COVID-19 health worries and peritraumatic distress among older adults

BACKGROUND

The present study examined whether subjective accelerated aging moderated the relationship between COVID-19 health worries and COVID-19 peritraumatic distress among older adults.

METHOD

The sample consisted of 277 older adults (M = 69.58, s.d. = 6.73, range 60-92) who answered an online questionnaire during the outbreak of COVID-19 pandemic in Israel. Participants completed the measures of background characteristics, exposure to COVID-19, COVID-19 health worries, subjective accelerated aging and COVID-19-based peritraumatic distress.

RESULTS

Higher levels of COVID-19 health worries were correlated with higher levels of peritraumatic distress symptoms among older adults. Moreover, those reporting accelerated aging also reported a higher level of peritraumatic distress. Finally, the interaction between COVID-19 health worries and subjective accelerated aging predicted peritraumatic distress, suggesting that COVID-19 worries were associated with peritraumatic distress to a stronger degree among older adults who felt they were aging faster.

CONCLUSIONS

These findings indicate that negative views of aging may serve as an amplifying factor for traumatic distress during the COVID-19 pandemic. Although preliminary, the findings provide insight for potential screening and interventions of older adults at risk of developing peritraumatic distress symptoms during the global pandemic.

Psychological aging, depression, and well-being

Aging is a multifactorial process, which affects the human body on every level and results in both biological and psychological changes. Multiple studies have demonstrated that a lower subjective age is associated with better mental and physical health, cognitive functions, well-being and satisfaction with life. In this work we propose a list of non-modifiable and modifiable factors that may possibly be influenced by subjective age and its changes across an individual's lifespan. These factors can be used for a future development of individual psychological aging clocks, which may be utilized as a sensitive measure for health status and overall life satisfaction. Furthermore, recent progress in artificial intelligence and biomarkers of biological aging have enabled scientists to discover and evaluate the efficacy of potential aging- and disease-modifying drugs and interventions. We propose that biomarkers of psychological age, which are just as important as those for biological age, may likewise be used for these purposes. Indeed, these two types of markers complement one another. We foresee the development of a broad range of parametric and deep psychological and biopsychological aging clocks, which may have implications for drug development and therapeutic interventions, and thus healthcare and other industries.

Impostorism, subjective age, and perceived health among aging veterans

RATIONALE

Aging veterans often suffer from increased vulnerability, manifested among other things in old subjective age and poor perceived health. Though research has documented the contribution of trauma related variables to these negative appraisals, their associations with impostorism (i.e., the subjective experience that one is less adequate than others perceive) remain unexamined.

OBJECTIVE

Filling this gap, this study explored the relations between impostorism and subjective age and perceived health among aging combat veterans.

METHOD

The study was conducted among 146 Israeli veterans of the 1973 Yom Kippur War. Participants were assessed for combat exposure, Posttraumatic Stress Disorder (PTSD) symptoms, and health-related behaviors during middle adulthood (1991; T1), and for subjective age, perceived health, impostorism, PTSD symptoms, and depressive symptoms during old age (2018; T2).

RESULTS

The veterans' impostorism was associated with relatively old subjective age and poor perceived health, above and beyond the effects of age, health-related behaviors, combat exposure, depressive symptoms, and PTSD symptoms.

CONCLUSIONS

The current results suggest that impostorism may contribute to veterans' stress and negatively affect their evaluations regarding age and health.

From the Frontline to the Homefront: The Experience of Israeli Veterans

In 1948, the state of Israel was created as a homeland for the Jewish people after 2,000 years of persecution and deportations in the diaspora. During the past 72 years, its inhabitants have experienced several wars and numerous terrorist attacks. Therefore, the issue of trauma goes beyond academic study, it is part of daily life. These circumstances have, unfortunately, turned Israel into a natural stress laboratory, which has enabled the systematic research of the biopsychosocial effects of traumatic stress on soldiers and civilians. This article reviews the findings of a series of studies that examine (a) the short- and long-term mental health effects of war on combat veterans; (b) the effects of repeated exposure to war on veterans; (c) trajectories of PTSD; and, specifically, (d) reactivation and (e) delayed-onset PTSD. We present the findings of two decades of systematic trauma research, which have followed the ongoing psychopathological effect of war on veterans. In understanding the ripple effects of trauma, it can be seen that veterans do not leave the events of the war behind once they are home; rather, it is with them wherever they go. Consequently, the trauma has a ripple effect that may carry over to veterans' spouses and offspring. The multiple manifestations and trajectories of both acute and chronic trauma will be presented. Clinical ramifications and implications will also be discussed.

What doesn't kill you makes you feel older: lifespan adversity and its association with subjective age among former prisoners of war

Background: Subjective age (SA) is an indicator of aging that has been empirically associated with health impediments and hindered longevity. Studies show that adverse life events may result in relatively older SA, but have not addressed the differential contribution of life events across the lifespan and the course of posttraumatic psychopathology on the SA of aging survivors of extreme trauma. Objective: Filling this gap, the current study explored the differential contribution of (1) adverse experiences in various life-stages and (2) trajectories of posttraumatic stress disorder (PTSD) to the prediction of SA in a sample of former prisoners-of-war as they enter old age. Method: A cohort of Israeli former prisoners-of-war of the 1973 Yom Kippur War (N = 103) was assessed at four points throughout four decades after the war. A linear hierarchical regression was utilized to assess the contribution of negative life events during childhood, participation in other wars, combat exposure, suffering in captivity, life events since the war and the trajectories of PTSD for predicting SA 42-years post-repatriation. Results: Lifespan adversity explained 50% of the variance in SA, with trajectories of PTSD making the largest contribution, followed by life events since the war. Negative life events in childhood added to the explained variance only when PTSD trajectories were accounted for. Exposure to combat, participation in additional wars and the severity of specific experiences during captivity did not reach significance, though the latter marginally contributed to the explained variance (p = .069). Conclusions: This study demonstrates the importance of considering the prolongation of posttraumatic psychopathology together with life adversities and their differential implications when addressing SA after extreme trauma. The findings suggest that early life adversity may be a latent factor that increases vulnerability to posttraumatic premature aging processes.

Understanding the long-term connections between posttraumatic stress, subjective age, and successful aging among midlife and older adults

Background: The nature of the reciprocal relationships between posttraumatic stress disorder (PTSD) symptoms, proportional subjective age, and their effects on successful aging are important issues that have been so far under-studied. Clarifying the relationships between these variables has many theoretical and practical implications for the understanding of how individuals age in the shadow of traumatic exposure. Objective: The present study examined the reciprocal relationships between PTSD symptoms and proportional subjective age in a longitudinal design, and how these variables predict successful aging. Method: Using in-region random digit dialling, we collected a stratified sample of community-dwelling older adults residing in the south of Israel. Of that sample, 132 midlife and older adults (T1 age range = 50-87, mean age = 65.84, SD = 9.12) were interviewed three times across a period of two years and four months (2014-2016). Participants completed measures of PTSD symptoms and proportional subjective age in the first two interviews (T1 and T2) and successful aging indices in the third interview (T3). PTSD symptoms and proportional subjective age measured at both T1 and T2 served as predictors and outcomes in a cross-lagged model and as predictors of successful aging at T3. Results: T1 PTSD symptoms predicted an older proportional subjective age at T2, whereas the reverse relationship (i.e. T1 proportional subjective age to T2 PTSD symptoms) was non-significant. Moreover, higher PTSD symptoms and an older proportional subjective age at T2 predicted lower successful aging at T3. Conclusions: In addition to clarifying the temporal sequencing of PTSD and proportional subjective age, the study further suggests that PTSD and proportional subjective age identity could each render midlife and older adults more susceptible to less successful aging. Accordingly, we advocate to further explore the mechanisms underlining these complicated relationships.

One 'knows': self-rated health and telomere length among ex-prisoners of war

OBJECTIVE

Ill-health and early mortality are amongst the most significant ramifications of trauma. Furthermore, trauma alters the subjective perception and experience of the body. The aim of this study is to examine the extent to which deteriorations in perceived health among traumatised individuals are associated with cellular health as manifested in telomere length.

METHODS

Specifically, 88 former prisoners of war (ex-POWs) evaluated their health (self-rated health; SRH) at 18 (T1), 35 (T2) and 42 (T3) years after the war, and were assessed for telomere length at T3. Health behaviour, BMI, morbidity and PTSD were also examined at T3.

RESULTS

The findings demonstrated that SRH was cross-sectionally correlated with telomere length. Furthermore, a significant sequential indirect effect was found, in which worse SRH in T1 was associated with shorter telomere length at T3, through worse SRH at T2 and at T3.

CONCLUSIONS

These findings demonstrate that long-term deteriorations in the subjective evaluations of health are implicated in actual cellular health among individuals exposed to trauma.

Subjective Age as a Moderator in the Reciprocal Effects Between Posttraumatic Stress Disorder Symptoms and Self-Rated Physical Functioning

It is now widely acknowledged that physical decline may increase among middle-aged and older adults who suffer from posttraumatic stress disorder (PTSD). Much less is known about the temporal sequencing of PTSD and physical decline relationship over time. While PTSD can lead to physical decline, physical decline may preserve or augment existing PTSD symptoms. Both problems can also mutually affect each other forming a vicious cycle. Additionally, it is important to address variables that can mitigate these longitudinal effects. Following the recovery capital framework, we consider how the existence or lack of capital in the form of young age identity may affect the recovery process. Therefore, the current study aimed to examine the reciprocal effects of PTSD symptoms and self-rated physical functioning and further test whether one's subjective age moderates these effects. Using in-region random digit dialing, we collected a stratified sample of community dwelling older adult residing in south Israel. Of that sample (N at T1 = 339), 132 older adults (age range = 51-88, mean age = 66.90, SD = 9.14) were interviewed 4 months after the 2014 Israel-Gaza conflict (T2) and 1 year later (T3). Participants responded to PTSD symptoms scale, and reported their physical functioning and subjective age. PTSD symptoms and self-rated physical functioning were tested as both predictors and outcomes in a cross-lagged model. The moderating effect of subjective age was assessed by examining whether T2 variables interacted with subjective age in predicting T3 outcomes. Results showed that higher PTSD symptoms at T2 were associated with subsequent lower self-rated physical functioning at T3, yet self-rated physical functioning at T2 did not predict PTSD symptoms at T3, thereby highlighting the PTSD self-rated physical function direction. Moreover, subjective age moderated this latter association, so that this relationship was significant only for those who felt relatively older. In addition to clarifying the temporal sequencing of the PTSD self-rated physical functioning association, the study further suggests that an older subjective age (i.e., lack of recovery capital) could render middle-aged and older adults more susceptible to physical decline following PTSD symptoms. We therefore propose to develop interventions aimed at coping with an older age identity and facilitating a younger age identity among traumatized older individuals.

Psychological vulnerability and resilience of Holocaust survivors engaged in creative art

Although evidence demonstrates that engagement in art promotes favorable coping with trauma, this subject is underexplored among Holocaust survivors. Thus, the present study explored whether Holocaust survivors engaged in art differed from survivors not engaged in art in various markers of psychological vulnerability and resilience. The study further included non-Holocaust survivor comparisons, some engaged in art and some not, in order to assess whether engagement in art among Holocaust survivors relates to a unique psychological profile beyond art engagement in general. A sample of 154 community-dwelling older adults (mean age = 81.67, SD = 5.33, range = 73-97) reported exposure to the Holocaust, current engagement in art, posttraumatic stress disorder (PTSD) symptoms, general psychological distress, resilience and subjective perceptions of age and aging. Holocaust survivors (regardless of whether they engaged in art or not) reported higher PTSD symptoms relative to comparisons. However, Holocaust survivors who engaged in art reported higher resilience than all other groups (survivors not engaged in art and comparisons engaged and not engaged in art). To the best of our knowledge, these findings are the first quantitative evidence pointing toward a link between engagement in art and positive coping with the Holocaust. These findings have important implications for clinicians working with Holocaust survivors.

Pathways Between Combat Stress and Physical Health Among Portuguese War Veterans

In this study, I explored the experience of both physical and psychological chronic illnesses among a sample of Portuguese war veterans. Twenty suffered from chronic posttraumatic stress disorder (PTSD; unrecovered) and 20 had remission from PTSD (recovered), and all participants suffered from a chronic physician-diagnosed medical disorder. Two semistructured interviews were conducted. Analysis of the interviews was conducted using the Thematic and Categorical Analysis. Unrecovered participants reported higher moral injury, discrepancy between pre- and postwar identity, medication side effects, and lower repertoire of coping strategies, and verbalized that treatment care plan triggers posttraumatic symptoms. Recovered participants reported stronger moral repair, sense of continuity between pre- and postwar identity, and wider repertoire of coping strategies, well-being. Veterans' adjustment to chronic physician-diagnosed medical disorders is related to the accommodation of war traumatic experiences within existing self-schemas to restore a sense of continuity between veterans' pre- and postwar identity.

Felt Age, Desired, and Expected Lifetime in the Context of Health, Well-Being, and Successful Aging

This study examines the interrelations of three different aspects of the subjective age: felt, desired and expected, as well as their relations with the chronological age (CA), health, and psychological well-being variables. Four hundred and twenty-three community-dwelling Croatian adults, aged 60-95 years, participated in the study. All three subjective age measures significantly correlated with the CA. Self-rated health were better predictors of the subjective age compared to the psychological variables. Among psychological variables, successful aging was the only significant predictor of the felt and expected age, while optimism showed to be the only significant predictor of the desired age. Results indicate the importance of some sociodemographic, psychological, and health variables for understanding older persons' subjective age identity and their desires and expectations regarding length of life. Besides the CA, it is very useful to include subjective age measures in research with elderly people.

“Caught in a Generation Gap”: A Generation Perspective on Refugees Getting Old in Denmark—A Qualitative Study

Purpose: Older non-Western migrants in Europe are a vulnerable population, due to old age and multiple disadvantages related to language barriers and different understandings of care, health, and disease. Our aim was to gain a better understanding and insight into the care needs of families with refugee background Method: The study was designed as a qualitative exploration using semistructured individual interviews and family group interviews. Results: The results illustrate how vulnerability can “transmit” from one family member to another. Discrepancies between the older person’s expectations and needs and society’s expectations trap family members in ethical and moral dilemmas. This divides and stresses the family and results in difficult decision making, increased stress, and vulnerability. Conclusion and Implication: Migration and displacement can lead to ambivalent feelings among younger relatives regarding their role in caring for older relatives. Health professionals need to address and acknowledge this to be able to provide culturally congruent health care.

Whole-genome DNA methylation status associated with clinical PTSD measures of OIF/OEF veterans

Emerging knowledge suggests that post-traumatic stress disorder (PTSD) pathophysiology is linked to the patients' epigenetic changes, but comprehensive studies examining genome-wide methylation have not been performed. In this study, we examined genome-wide DNA methylation in peripheral whole blood in combat veterans with and without PTSD to ascertain differentially methylated probes. Discovery was initially made in a training sample comprising 48 male Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans with PTSD and 51 age/ethnicity/gender-matched combat-exposed PTSD-negative controls. Agilent whole-genome array detected ~5600 differentially methylated CpG islands (CpGI) annotated to ~2800 differently methylated genes (DMGs). The majority (84.5%) of these CpGIs were hypermethylated in the PTSD cases. Functional analysis was performed using the DMGs encoding the promoter-bound CpGIs to identify networks related to PTSD. The identified networks were further validated by an independent test set comprising 31 PTSD+/29 PTSD- veterans. Targeted bisulfite sequencing was also used to confirm the methylation status of 20 DMGs shown to be highly perturbed in the training set. To improve the statistical power and mitigate the assay bias and batch effects, a union set combining both training and test set was assayed using a different platform from Illumina. The pathways curated from this analysis confirmed 65% of the pool of pathways mined from training and test sets. The results highlight the importance of assay methodology and use of independent samples for discovery and validation of differentially methylated genes mined from whole blood. Nonetheless, the current study demonstrates that several important epigenetically altered networks may distinguish combat-exposed veterans with and without PTSD.

Subjective age and perceived distance-to-death moderate the association between posttraumatic stress symptoms and posttraumatic growth among older adults

OBJECTIVES

Little research has addressed the association between posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG) in the second half of life. This study examined whether subjective age and perceived distance-to-death moderate this association.

METHOD

339 community-dwelling older adults (age range 50-90; M = 65.44, SD = 9.77) were sampled through random dialing to Jewish residents in the south of Israel. Participants completed a phone-questionnaire on PTS symptoms, level of PTG, subjective age, and perceived distance-to-death.

RESULTS

Higher levels of PTS symptoms were both linearly and curvilinearly related to higher PTG. Additionally, subjective age and perceived distance-to-death moderated this association in a linear way, so that the association was strongest in participants who reported younger subjective age and further distance-to-death.

DISCUSSION

The findings emphasize the moderating effect of two time perspectives, one that focuses on time since birth and another that concerns the time that remains before death. These two perspectives affect the association between posttraumatic stress and posttraumatic growth within older individuals.

The lifelong struggle of Finnish World War II veterans

OBJECTIVES

In many countries veterans from World War II are growing old. Research has shown that war experiences continue to impact those who have been involved in war for a long time. The present study targets old injured war veterans from World War II in Finland. The aim of this study was to produce knowledge of the impact of war experiences and injuries on the lifespan of Finnish war veterans.

METHOD

The method used was grounded theory. Data were collected by interviewing 20 aged war veterans in their homes.

RESULTS

The analysis resulted in four categories, with also subcategories: (1) lost childhood and youth; (2) war traumas impacting life; (3) starting life from scratch; and (4) finding one's own place. A substantive theory of war veterans' lifelong struggle for freedom throughout the lifespan was outlined.

CONCLUSION

The war overshadowed the whole lifespan of the veterans, but in old age they finally felt free. Since war experiences vary depending on historical context, a formal theory would require additional research.

The interactive effect of subjective age and subjective distance-to-death on psychological distress of older adults

OBJECTIVES

Subjective age refers to how young or old people experience themselves to be, while subjective distance-to-death reflects how far or close they experience themselves to be from their death. The present study examined whether subjective age and subjective distance-to-death interact in predicting psychological distress.

METHOD

A sample of 1073 community-dwelling older adults at the age range of 50-86 (M = 58.1, SD = 5.3) evaluated their subjective age, subjective distance-to-death, psychological distress, and rated several measures of physical health.

RESULTS

After controlling for background characteristics and physical health indices, perceiving death as far and reporting younger subjective age predicted lower psychological distress. The combination of feeling close to death and older subjective age was related to the highest ratings of psychological distress. Moreover, the effect of subjective distance-to-death on psychological distress was mitigated by younger subjective age.

CONCLUSION

The findings underscore the importance of an integrative view of two time perspectives - one that focuses on time since birth and another that concerns time left till death - to psychological distress of older adults.

Subjective Age and Health in Later Life: The Role of Posttraumatic Symptoms

OBJECTIVES

We examined: (a) long-term effects of war-related trauma and captivity on posttraumatic stress symptoms (PTSS), physical health, and subjective age; and (b) the moderation effect of PTSS and health on subjective age among ex-prisoners of war (ex-POWs) and war veterans.

METHOD

Israeli veterans of the 1973 Yom Kippur War (mean age 57 years), including 111 ex-POWs and 167 matched veterans were assessed for subjective age, war-related PTSS, and health-related measures (physical symptoms, somatization, health-risk behaviors, and self-rated health).

RESULTS

Controlling for age, ex-POWs endorsed higher subjective age than controls, and ex-POWs with posttraumatic stress disorder (PTSD) endorsed higher subjective age than ex-POWs and controls without PTSD. PTSS and health measures besides health-risk behaviors predicted subjective age. Significant interactions were found between PTSS and each health measure, suggesting that health only predicts subjective age for those reporting high PTSS.

DISCUSSION

PTSS appear to be implicated in the link between health measures and subjective age in later life, pointing to the long-term effect of captivity and war-induced traumatic distress on aging.

Age differences in PTSD among Canadian veterans: age and health as predictors of PTSD severity

ABSTRACT Background: To date, few studies have investigated age differences in posttraumatic stress disorder (PTSD) symptoms and none has examined age differences across symptom clusters: avoidance, re-experiencing, and hyperarousal. The first objective of this study was to investigate age differences in PTSD and its three symptom clusters. The second objective was to examine age and indices of health as predictors of PTSD symptom severity. Methods: Participants were 104 male veterans, aged 22 to 87 years, receiving specialized mental health outpatient services. Assessments included measures of health-related quality of life, pain severity, number of chronic health conditions, and symptoms of PTSD, both in total and on the symptom clusters. Results: There were significant age differences across age groups, with older veterans consistently reporting lower PTSD symptom severity, both in total and on each of the symptom clusters. Hierarchical regression analyses indicated that the inclusion of health indices accounted for significantly more variance in PTSD symptoms over and above that accounted for by age alone. Pain severity was a significant predictor of PTSD total and the three symptom clusters. Conclusions: This is the first study to report lower levels of PTSD severity among older veterans across symptom clusters. These findings are discussed in relation to age differences in the experiencing and processing of emotion, autobiographical memory, and combat experiences. This study also emphasizes the importance of assessing pain in those with symptoms of PTSD, particularly older veterans who are less likely to receive specialized mental healthcare.

Predictors of subjective age in people aged 40-79 years: a five-year follow-up study. The impact of mastery, mental and physical health

OBJECTIVES

Assessing subjective age perception (SAP) and changes in SAP as well as exploring which variables of socio-demographic, health and personal mastery independently predicted SAP.

METHODS

The panel data are from two waves of the Norwegian Study on the Life Course, Ageing and Generations (NorLAG). Our sample consists of 2471 people aged 40-79 years at baseline who were surveyed in 2002/2003 (T1) and 2007/2008 (T2). Univariate and multiple regressions were performed; multivariate analyses assessing the relative importance of the independent variables (at T1) for the SAP at T2.

RESULTS

Older chronological age, good physical health, good mental health, a high level of personal mastery and having lower education significantly predicted a youthful SAP. For the whole sample, older age and a high level of personal mastery were the most important predictors. For those aged 40-49 being a man, having lower education, good physical health and high personal mastery predicted a younger SAP, whereas in the group aged 50-59 years being married/cohabiting and having a high level of education were predictors of an older SAP. For those aged 60-69, high personal mastery was the only independent predictor of a younger SAP. For those aged 70-79 years, only health - good mental and physical health - independently predicted a younger SAP.

CONCLUSIONS

Most respondents feel younger than their chronological age, the more the older they are. Self-rated physical and mental health and personal mastery are associated with SAP and vary in different age groups.

Greater age-related decline in markers of physical, mental and cognitive health among Israeli older adults exposed to lifetime cumulative adversity

OBJECTIVES

This longitudinal investigation addressed whether and how lifetime cumulative adversity and depressive symptoms moderated age-related decline in markers of physical, mental, and cognitive health.

METHOD

1248 older adults (mean age = 62 at Wave 1) who completed the first two waves of the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE-Israel) reported on exposure to potentially traumatic life events, depressive symptoms, and three outcomes - disability, quality of life, and cognitive markers.

RESULTS

Age was related to greater functional decline in outcome measures across the two waves (i.e., increase in disability and decrease in quality of life and cognitive functioning). This age-related decline became stronger as lifetime adversity increased. A three-way interaction showed that the greatest age-related functional decline in outcome measures was especially salient among those with high level of lifetime adversity and high level of depressive symptoms.

CONCLUSION

Lifetime cumulative adversity is associated with a more noticeable process of age-related dysfunction across various markers of health. Although the majority of older adults are resilient to lifetime adversity, prevention and intervention programs should be aimed at mitigating the pronounced senescence observed when adversity accumulated to a large degree, and especially when it is accompanied with high level of distress.

N-glycosylation profiling of plasma provides evidence for accelerated physiological aging in post-traumatic stress disorder

The prevalence of age-related diseases is increased in individuals with post-traumatic stress disorder (PTSD). However, the underlying biological mechanisms are still unclear. N-glycosylation is an age-dependent process, identified as a biomarker for physiological aging (GlycoAge Test). To investigate whether traumatic stress accelerates the aging process, we analyzed the N-glycosylation profile in n=13 individuals with PTSD, n=9 trauma-exposed individuals and in n=10 low-stress control subjects. Individuals with PTSD and trauma-exposed individuals presented an upward shift in the GlycoAge Test, equivalent to an advancement of the aging process by 15 additional years. Trauma-exposed individuals presented an intermediate N-glycosylation profile positioned between severely traumatized individuals with PTSD and low-stress control subjects. In conclusion, our data suggest that cumulative exposure to traumatic stressors accelerates the process of physiological aging.

Age identity, self-rated health, and life satisfaction among older adults in Dakar, Senegal

The objectives of this quantitative study were to (1) ascertain to what extent older adults aged 50 and above feel and desire to be younger than their age, and classify themselves as young versus old; (2) compare these patterns with those found among other cross-cultural populations; and (3) assess the extent to which self-rated health and life satisfaction predict age identities. This study was carried out on a sample of 500 dwellers of the Senegalese capital aged 50 and older. This sample was constructed using the quota method to strive for representativeness. Most of the respondents wanted to be younger than their chronological age (51.8 %), but only 27.8 % felt younger than they were. Moreover, 80 % of the sample claimed to be old. Self-rated health predicted felt age and the feeling of being old. Furthermore, the less-satisfied Dakar residents were with their life, the younger they wanted to be. We first discuss our results in a comparative perspective focused on how orientations toward individualism and collectivism could be related to age identity, and on demographic characteristics of the Senegalese population-where life expectancy is 59.3 years old. We then analyze the relevance of age identity dimensions as indicators of successful aging in Dakar.

PTSD in the elderly: the interaction between trauma and aging

BACKGROUND

Because an increasingly large cohort of individuals is approaching their elderly years, there is concern about how the healthcare system will cope with the greater demands placed upon it. One area of concern is the impact of trauma and post traumatic stress disorder (PTSD) in the aged. Although several reviews have highlighted the lack of knowledge and research on the topic, there still remain gaps in the literature. Nevertheless, some recent behavioral, endocrinological and neuroimaging studies may provide new insights into the discussion. The central aims of this paper are to summarize the etiological, epidemiological and clinical aspects of PTSD, trauma, and the elderly, and to integrate this knowledge with (i) what is known about PTSD in adults, and (ii) the behavioral, hormonal and cerebral changes associated with healthy aging.

METHODS

A comprehensive search was performed with ISI Web of Science and PubMed for articles pertinent to the psychology and biology of PTSD, trauma, and the elderly.

RESULTS

There exist both significant similarities and differences between adults and elderly with PTSD concerning cognitive and biological profile. Evidence suggests that PTSD in the elderly does not follow a simple clinical trajectory.

CONCLUSIONS

PTSD in the elderly must be considered within the context of normal aging. Strong claims about an interaction between PTSD and aging are difficult to make due to sample heterogeneity, but it is clear that PTSD in this age group presents unique aspects not seen in younger cohorts. Further research must integrate their studies with the biological, psychological, and social changes already associated with the aging process.

Subjective health and memory self-efficacy as mediators in the relation between subjective age and life satisfaction among older adults

OBJECTIVE

Perceiving oneself as younger than one's actual age functions as a self-enhancing positive illusion that promotes life satisfaction. However, no research has yet focused on the mechanisms through which a youthful subjective age could be related to higher life satisfaction. The purpose of this study was to identify the mediating role of resources, such as subjective health and memory self-efficacy, in the relation between subjective age and life satisfaction among older adults.

METHOD

A cross-sectional study was conducted with 250 older individuals aged from 60 to 77 years who completed measures of subjective age, subjective health, memory self-efficacy, and life satisfaction.

RESULTS

Path analysis revealed that subjective age was positively related to both subjective health and memory self-efficacy, and that subjective health and memory self-efficacy were both positively related to life satisfaction. Bootstrap procedures further indicated that subjective age has significant total and specific indirect contribution to life satisfaction through subjective health and memory self-efficacy.

DISCUSSION

This study fills a gap in existing literature and suggests that a youthful subjective age is associated with higher life satisfaction because it is related to higher evaluation of health and memory self-efficacy. It provides an initial support for a resource-based explanation of the relation between subjective age and life satisfaction.