Trauma history is associated with psychological distress and somatic symptoms in homebound older adults

Am J Geriatr Psychiatry. 2009 Sep;17(9):810-8. doi: 10.1097/JGP.0b013e3181b20658.

Abstract

Objectives: To examine the physical health, anxiety, and depressive symptoms of homebound older adults in relation to a history of trauma exposure.

Design: Secondary analysis of cross-sectional data.

Setting: Participants were recruited by in-home aging services case managers.

Participants: The sample consisted of 136 older adults receiving in-home services.

Measurements: Participants completed a research battery that included the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID), Modified Mini-Mental Status Examination, and Brief Symptom Inventory-18 (BSI-18). Case managers provided standard assessments of health and functional status. Data were analyzed using t tests, chi tests, and logistic regression.

Results: Approximately half (49%) of the participants reported experiencing a traumatic event. When compared with participants who did not report a history of trauma, trauma-exposed participants were on average 3 years younger, had one more chronic medical condition, were taking two more nonpsychotropic medications, and were more likely to report poor self-rated health. Furthermore, trauma-exposed participants were more likely to experience clinically significant somatic and anxiety symptoms on the BSI-18 and were more likely to meet criteria for a SCID anxiety disorder diagnosis. After controlling for physical health and cognitive functioning, trauma exposure was still associated with psychiatric disorders and higher levels of somatic and anxiety symptoms.

Conclusions: Trauma-exposed participants were younger but experienced worse physical and mental health than those without a trauma history. This suggests that trauma exposure across the lifespan could have a long-term negative impact on homebound older adults' health and quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / psychology
  • Depression / diagnosis*
  • Depression / psychology
  • Female
  • Geriatric Assessment
  • Health Status
  • Homebound Persons / psychology*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Quality of Life
  • Somatoform Disorders / diagnosis*
  • Somatoform Disorders / epidemiology
  • Somatoform Disorders / psychology
  • Surveys and Questionnaires
  • Wounds and Injuries / psychology*