Abstract
Trauma-exposed adults with high levels of posttraumatic stress symptoms (PTSS) report poorer health-related quality of life (HRQOL), but less is known about the persistence of this relationship over time. Participants from the Vietnam Era Twin Study of Aging reported on PTSS, health, and sociodemographic characteristics at average age 38; 775 participants reported having been exposed to trauma. Later, at average ages 56 and 62, mental and physical HRQOL were assessed with the Short-Form 36. Premorbid risk for anxiety/neuroticism was evaluated with a polygenic risk score derived from a large genome-wide association study meta-analysis. In multivariate mixed models, having higher levels of PTSS, poorer self-rated health, lower income, and less education at age 38 were associated with worse physical and mental HRQOL two decades later. Chronic health problems at age 38 predicted midlife physical but not mental HRQOL. Although genetic risk for neuroticism was correlated with HRQOL and PTSS, it was no longer significant in multivariate models. Health-related quality of life (HRQOL) predicts morbidity and mortality independently of objective health measures; early interventions may help to mitigate the ongoing impact of trauma on quality of life.
Highlights
IntroductionHealth-related quality of life (HRQOL) has emerged as an important concept in aging research because it predicts mortality and morbidity above and beyond measures of objective health [1,2,3,4]
Health-related quality of life (HRQOL) has emerged as an important concept in aging research because it predicts mortality and morbidity above and beyond measures of objective health [1,2,3,4].Measures of HRQOL typically encompass multiple components of subjective health such as the perceived severity and persistence of health problems, as well as their interference with life and their effect on mental wellbeing—none of which is captured by knowing if someone has a disease or disorder [2]
In order to test the hypothesis that posttraumatic stress symptoms (PTSS) are associated with signs of more rapid aging, we examined a PTSS by time interaction, wherein a greater decline in HRQOL over time among those with more posttraumatic stress disorder (PTSD) symptoms would be one indication of more pathological aging
Summary
Health-related quality of life (HRQOL) has emerged as an important concept in aging research because it predicts mortality and morbidity above and beyond measures of objective health [1,2,3,4]. Measures of HRQOL typically encompass multiple components of subjective health such as the perceived severity and persistence of health problems, as well as their interference with life and their effect on mental wellbeing—none of which is captured by knowing if someone has a disease or disorder [2]. Adults with high levels of posttraumatic stress symptoms (PTSS) report poorer HRQOL, but less is known about the persistence of this relationship over time [5]. Res. Public Health 2020, 17, 4554; doi:10.3390/ijerph17124554 www.mdpi.com/journal/ijerph
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