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.
Key Words
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Article info
Publication history
Published online: May 07, 2015
Accepted:
April 1,
2015
Received in revised form:
March 23,
2015
Received:
January 12,
2015
Footnotes
Supplemental digital content is available for this article in the HTML and PDF versions of this article on the journal's Web site (www.ajgponline.org).
James B. Lohr and Barton W. Palmer contributed equally to the paper.
Identification
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Published by Elsevier Inc.
