PTSD Is Associated with Accelerated Aging

Research from the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System published online in the American Journal of Geriatric Psychiatry suggests that patients with post-traumatic stress disorder (PTSD) appear to be at risk for accelerated aging, or premature senescence.

Whereas previous studies have found PTSD to be associated with chronic depression, anger, insomnia, eating disorders, substance abuse and several other psychological disorders, “This is the first study of its type to link PTSD, a psychological disorder with no established genetic basis, which is caused by external, traumatic stress, with long-term, systemic effects on a basic biological process such as aging,” said senior author Dilip V. Jeste, MD, Distinguished Professor of Psychiatry and Neurosciences and director of the Center on Healthy Aging and Senior Care at UC San Diego.

Prior research has also indicated a link between premature senescence and other psychiatric conditions, including schizophrenia and bipolar disorder. With the hypothesis that evidence indicating a link between PTSD and premature senescence would have major implications for quality of life and healthcare policy, Jeste and colleagues “conducted a comprehensive review of published empirical studies relevant to early aging in PTSD” that were published since 2000. Their search through the PubMed, PsychINFO, and PILOTS databases included studies of biomarkers of senescence (leukocyte telomere length and pro-inflammatory markers), the prevalence of senescence-associated medical conditions, and mortality rates.

The literature review identified 64 relevant studies, 22 of which were suitable for calculating overall effect sizes for biomarkers, and 10 for mortality.

Of six studies that specifically assessed leukocyte telomere length, all found reduced telomere length in patients with PTSD, a strong indicator of aging in cells.

Evidence across studies consistently showed an association between PTSD and pro-inflammatory markers, such as C-reactive protein and tumor necrosis factor alpha

“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,” wrote the authors.

The investigators also found that seven of 10 studies indicated a mild-to-moderate association between PTSD and early mortality, which was consistent with an early onset or acceleration of aging in PTSD.

“These findings do not speak to whether accelerated aging is specific to PTSD, but they do argue the need to re-conceptualize PTSD as something more than a mental illness,” said first author James B. Lohr, MD, professor of psychiatry and director of the Center for Excellence for Stress and Mental Health of the Veterans Affairs San Diego Healthcare System. “Early senescence, increased medical morbidity and premature mortality in PTSD have implications in health care beyond simply treating PTSD symptoms. Our findings warrant a deeper look at this phenomenon and a more integrated medical-psychiatric approach to their care.”

The study authors noted that additional research is needed to understand the nature of the association between PTSD and accelerated senescence. “There may be a need to re-conceptualize PTSD beyond the boundaries of mental illness, and instead as a full systemic disorder,” they concluded.