PTSD At Late Life: Context and Treatment

Abstract

Posttraumatic stress disorder (PTSD) in older adults has been linked to impairment in health and functioning, resulting in accelerated aging and increased healthcare utilization. The experience of trauma and associated mental health difficulties, including PTSD, may impact or be impacted by the aging process. It may also influence treatment engagement and outcome. Unfortunately, older adults are not well represented in PTSD treatment outcome studies. However, some of the evidence-based psychotherapies for PTSD recommended by treatment guidelines have been investigated in older adults. Standard exposure therapies appear to work well for addressing PTSD symptoms in older adults during the treatment phase, but perhaps not as well during the maintenance phase compared to younger cohorts. The limits to clinical improvements in the available studies suggest a need for enhancing engagement and adherence for the older population. It has been suggested that benefits rendered by psychotherapies for severe, chronic PTSD may not be fully or accurately captured by standard self-report PTSD outcome measures. Additional clinical considerations are discussed regarding older adults with cognitive impairments or residing in long-term care facilities, as well as pharmacological considerations. Despite the limited PTSD treatment research with older adults, the evidence available to date suggests that older adults can benefit from evidence-based psychotherapies for PTSD.