期刊
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY
卷 23, 期 7, 页码 709-725出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jagp.2015.04.001
关键词
PTSD; aging; mortality; telomere; dementia
资金
- VA Center of Excellence for Stress and Mental Health (CESAMH)
- National Institutes of Health [R01 MH099987, R01 MH094151, T32 MH019934]
- Department of Defense [W81XWH-12-1-0614]
- University of California
- San Diego Center for Healthy Aging
- Sam and Rose Stein Institute for Research on Aging
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.
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