Posttraumatic stress disorder in the elderly: A review

Posttraumatic disorder (PTSD) In elderly persons impairs their ability to d eal with subsequent life stress and to negotiate the developmental stages o f late life successfully. If can stem from trauma at any point in life. Sym ptoms may be persistent or intermittent, and the disorder may be time-limit ed or chronic. Increasing severity of trauma and premorbid psychiatric illn ess predispose to the development of PTSD, and certain personality traits a nd good psychosocial support protect against it. Elderly individuals do not appear more predisposed than young persons to develop PTSD, and symptoms o f the disorder are similar across age groups: reexperiencing the trauma, av oidance, and hyperarousal. Dysfunctions of the adrenergic system and the hy pothalamic-pituitary-adrenal axis have been Implicated in the neurobiology of PTSD, although there is no current evidence that the changes seen in the se systems with aging affect the development or presentation of PTSD in old er individuals. Antidepressants, group therapy, and cognitive-behavioral th erapy are presently the mainstays of treatment, although to date no systema tic and controlled research has been done on the treatment of PTSD In this age group.