Posttraumatic Stress Disorder in Older Veterans admitted to VA Community Living Centers: Prevalence and Risk Correlates

Abstract

ObjectivesTo examine prevalence and risk correlates for post-traumatic stress disorder (PTSD) occurring during or after admission to a Veterans Administration (VA) skilled nursing facility. DesignRetrospective cohort analysis of electronic health record information extracted from the VA Corporate Data Warehouse. SettingUnited States VA skilled nursing facility. Participants57,414 Veterans age 60+ with an admission during five fiscal years, 2018–2022, excluding those who died within six months of admission or were still admitted. MeasurementsThe dependent variable was PTSD diagnosis during or six-months following the admission. Risk correlates examined were: age, gender, race, rurality, clinical complexity, prior dementia diagnosis, length of stay, and facility size; odds ratios (OR) and confidence intervals (CI) are provided for each correlate. Results19.1% of Veterans had a diagnosis of PTSD, associated with younger age (age 60–69 compared to age 80+; OR: 2.92, 95% CI: 2.70–3.14; age 70–79 compared to age 80+ OR: 4.51, 95% CI: 4.20–4.84); female gender (OR: 1.65, 95% CI: 1.50–1.82); minoritized race (OR: 1.17, 95% CI: 1.12–1.23); higher clinical complexity (OR:1.22, 95% CI: 1.17–1.28). As compared to Veterans who had a prior PTSD diagnosis, Veterans with newly diagnosed PTSD were more likely to be older (age 60 group OR= 0.59, 95% CI:0.51–0.70; age 70 group OR= 0.54, 95% CI:0.46–0.62,), rural (OR=1.14, 95% CI:1.04–1.24) and admitted to a larger facility (OR=1.22, 95% CI:1.12–1.33). ConclusionsPTSD is a significant concern for older Veterans admitted to VA skilled nursing facilities, supporting the need for trauma-informed care, particularly for those most at risk.