In recent years, public health concerns about post-traumatic stress disorder (PTSD) have risen significantly, driven in part by affected military veterans returning from conflicts in the Middle East and elsewhere. PTSD is associated with number of psychological maladies, among them chronic depression, anger, insomnia, eating disorders and substance abuse.
Researchers at University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System suggest that people with PTSD may also be at risk for accelerated aging or premature senescence. Their results appear in the May 7 online issue of American Journal of Geriatric Psychiatry.
“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 study 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.
Existing research has pointed to a potential association between psychiatric conditions, such as schizophrenia and bipolar disorder, and acceleration of the aging process. This investigation attempted to determine whether PTSD might show a similar association by analyzing previously published studies related to PTSD and aging, going back to 2000.
There is no standardized definition of premature aging, also known as accelerated senescence. For guidance, the researchers looked at early aging phenomena associated with non-psychiatric conditions, such as Hutchinson-Gilford progeria syndrome, HIV infection and Down’s syndrome.
The majority of evidence fell into three categories: biological indicators or biomarkers, such as leukocyte telomere length (LTL), (a complex genetic trait associated with aging), earlier occurrence or higher prevalence of medical conditions associated with advanced age and premature death.
The scientists found consistent evidence of changes in telomeres in people with PTSD as well as increased pro-inflammatory markers associated with PTSD. Their analysis revealed that PTSD was present alongside several targeted conditions associated with normal aging, including cardiovascular disease, type 2 diabetes, gastrointestinal ulcer disease and dementia. There was also a mild-to-moderate association of PTSD with earlier mortality, 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. “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.”
However, researchers caution that more long-term studies are needed to directly demonstrate accelerated aging in people with PTSD and to determine why.