Cumulative Trauma In Adulthood Can Worsen Health In Later Years

In a study of 1,518 older adults from a nationwide survey, researchers Neal Krause, Ph.D., of the University of Michigan, Benjamin A. Shaw, Ph.D., of the University of Albany at SUNY and John Cairney, Ph.D., at Toronto University examined whether cumulative trauma across a person's lifetime affected a person's self-rated health, occurrence of acute and chronic conditions and functional disability. Three different ages in the study were examined: young old (65-74), old old (75-84) and oldest old (85 and older).

The results show that trauma occurring between 18 and 30 years and between 31 to 64 years had the greatest affect on the person's current health. Interestingly, say the authors, adversity encountered in adult life affected adult health more than adversity encountered in childhood. "Trauma could have the same adverse effects on children as adults, but the effects on children may dissipate by the time they reach adulthood, " said Krause.

The young old (age 65-74) seem to be affected the most by their traumatic events and this may be because of historical reasons, said Dr. Krause. This age group grew up after WWII during the Eisenhower years and experienced good economic times for most of their adulthood. "They placed a lot of value on stability and living the American Dream. If and when their expectations and dreams were changed dramatically by a traumatic event, their coping abilities may not have been developed enough to help them. This set them up for health problems in their later years."

The second oldest group – the old old group may have built up some resilience from growing up in a time period that prepared them for later adversities, said the authors. This group faced WWII and was surrounded by all the stresses of war and economic shortages. They were patriotic, self-reliant and had a respect for authority and were able to handle self-sacrifice. These conditions probably helped them develop some resilience against unexpected trauma in their later years, said the authors.

Those born before 1919 (the oldest old) who entered adulthood during the Great Depression – a time of great insecurity – may be similar to the youngest group as far as being more vulnerable to traumatic events. This group was likely to be more afraid of taking risks because of growing up in an economic climate of desperation. According to the authors, this age group may not have mastered certain problem solving skills because of their fear of the unknown. This may have hindered their ability to develop better coping responses to adversity, said the authors.

Some of the 22 traumas examined in the study were: had a spouse die; had a child die; had been in a disaster; had a serious/life-threatening illness; had to repeat a year of school before the age of 18; had either parent experience unemployment for a period of time before the age of 18 or had either parent die before the age of 18.

From these study findings, said Dr. Krause, health practitioners can extrapolate why some older people fall ill while others do not. "It may be necessary to routinely ask older people who are having health problems if they experienced a trauma during the intake examination. Many health care providers already ask about stressful events when taking medical histories but knowing if trauma existed may provide additional insight to a person's current state of health," said Dr. Krause.

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Article: "A Descriptive Epidemiology of Lifetime Trauma and the Physical Health Status of Older Adults," Neal Krause, Ph.D., University of Michigan; Benjamin A. Shaw, Ph.D., University of Albany, State University of New York; John Cairney, Ph.D., University of Toronto; Psychology and Aging, Vol. 19, No. 4.

Full text of the article is available from the APA Public Affairs Office or at http://www.apa.org/journals/pag/press_releases/december_2004/pag194637.html

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