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Is Post-Traumatic Stress Disorder Associated with Premature Senescence? A Review of the Literature.

aging

cardiovascular

dementia

senescence

stress

telomere length

Authors: James B JB. Lohr, Barton W BW. Palmer, Carolyn A CA. Eidt, Smitha S. Aailaboyina, Brent T BT. Mausbach, Owen M OM. Wolkowitz, Steven R SR. Thorp, Dilip V DV. Jeste
Published: 05/07/2015, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry

Objective

Post-traumatic stress disorder (PTSD) has major public health significance. Evidence that PTSD may be associated with premature senescence (early or accelerated aging) would have major implications for quality of life and healthcare policy. We conducted a comprehensive review of published empirical studies relevant to early aging in PTSD.

Method

Our search included the PubMed, PsycINFO, and PILOTS databases for empirical reports published since the year 2000 relevant to early senescence and PTSD, including: 1) biomarkers of senescence (leukocyte telomere length [LTL] and pro-inflammatory markers), 2) prevalence of senescence-associated medical conditions, and 3) mortality rates.

Results

All six studies examining LTL indicated reduced LTL in PTSD (pooled Cohen's d = 0.76). We also found consistent evidence of increased pro-inflammatory markers in PTSD (mean Cohen's ds), including C-reactive protein = 0.18, Interleukin-1 beta = 0.44, Interleukin-6 = 0.78, and tumor necrosis factor alpha = 0.81. The majority of reviewed studies also indicated increased medical comorbidity among several targeted conditions known to be associated with normal aging, including cardiovascular disease, type 2 diabetes mellitus, gastrointestinal ulcer disease, and dementia. We also found seven of 10 studies indicated PTSD to be associated with earlier mortality (average hazard ratio: 1.29).

Conclusion

In short, evidence from multiple lines of investigation suggests that PTSD may be associated with a phenotype of accelerated senescence. Further research is critical to understand the nature of this association. There may be a need to re-conceptualize PTSD beyond the boundaries of mental illness, and instead as a full systemic disorder.

Published by Elsevier Inc.
PubMed Full Text