Mental Health Weekly

December 13, 2004 - Cumulative trauma during a person's life can have an overall effect on health in later years, according to a study that examines the consequences of traumatic events on older adults' physical health. Also, traumas experienced in adulthood compared to traumas experienced in childhood appear to cause more damage to an older person's (65 and older) health, say researchers of a new study reported on in this month's Psychology and Aging, published by the American Psychological Association (APA).

Traumas are distinguished from other types of stressful life events by their seriousness, and include experiencing a serious or life threatening illness, witnessing a violent crime or being in combat.

In a study of 1,518 older adults from a nationwide survey, researchers Neal Krause, Ph.D., of the University of Michigan, Benjamin A. Shaw, Ph.D., of the State University of New York at Albany and John Cairney, Ph.D., at Toronto University examined whether cumulative trauma across a person's lifetime affected a persons self-rated health, occurrence of acute and chronic conditions and functional disability. Three different ages in the study were examined: young old (65-74), old old (75-84) and oldest old (85 and older).

The results show that trauma occurring between 18 and 30 years and between 31 to 64 years had the greatest affect on the person's current health. Interestingly, say the authors, adversity encountered in adult life affected adult health more than adversity encountered in childhood.

"Trauma could have the same adverse effects on children as adults, but the effects on children may dissipate by the time they reach adulthood," said Krause.

The young old (age 65-74) seem to be affected the most by their traumatic events and this may be because of historical reasons, said Dr. Krause. This age group grew up after World War II and experienced good economic times for most of their adulthood.

"They placed a lot of value on stability and living the American Dream. If and when their expectations and dreams were changed dramatically by a traumatic event, their coping abilities may not have been developed enough to help them. This set them up for health problems in their later years," said Krause.

The second oldest group, the old old group, may have built up some resilience from growing up in a time period that prepared them for later adversities, the authors wrote. This group faced World War II and was surrounded by all the stresses of war and economic shortages. They were patriotic, self-reliant and had a respect for authority and were able to handle self-sacrifice, the authors wrote. These conditions probably helped them develop some resilience against unexpected trauma in their later years.

Those born before 1919 (the oldest old) who entered adulthood during the Great Depression, a time of great insecurity 'may be similar to the youngest group as far as being more vulnerable to traumatic events, the authors wrote. This group was likely to be more afraid of taking risks because of growing up in an economic climate of desperation.

According to the authors, this age group may not have mastered certain problem-solving skills because of their fear of the unknown. This may have hindered their ability to develop better coping responses to adversity, the authors wrote.

Among the 22 traumas examined in the study were: the death of a spouse; the death of a child; direct impact from a natural disaster; a serious/life-threatening illness; repeating a year of school before the age of 18; had either parent experience unemployment for a period of time before the age of 18 or had either parent die before the age of 18.

According to Krause, these study findings can help health practitioners determine why some older people fall ill while others do not. "It may be necessary to routinely ask older people who are having health problems if they [have] experienced a trauma," said Krause.