In the later years of life, older adults report a high prevalence of traumatic events, which are associated with poorer physical and psychosocial health.
- Traumatic childhood events increase the risk of depression, fatigue, moderate to severe pain, dyspnea, loneliness, and low life satisfaction in late life.
- Repeating a grade is one of the most common potentially traumatic events in childhood.
- According to the authors, a patient’s needs must be considered through the prism of trauma.
Health authorities recognize that experienced trauma is relevant to the clinical care of adults at the end of life. In a recent study, researchers from UC San Francisco and the University of Michigan (United States) decided to determine the prevalence of early life and cumulative trauma among older adults, as well as the association traumatic events with physical, mental and social well-being in old age.
Pain, depression, loneliness: more risks in people with trauma
To carry out their work, published in the journal Journal of the American Geriatrics Societythey followed 6,495 Americans aged over 50. Participants were asked to complete a questionnaire about their experiences with 11 traumatic events, as well as their psychosocial well-being. They were interviewed every two years until their death, which occurred at an average age of 78 years. A final “interview” with a family member or friend with power of attorney provided information on symptoms (pain, fatigue, dyspnea, depression) and problems encountered (loneliness, social isolation) during their last year of life.
Results showed that trauma across the lifespan was common, with variation in individual events by gender and year of birth. According to research, trauma is associated with depression and anxiety. In detail, people traumatized by five or more events had a 40% probability of suffering from it at the end of life, compared to 24% of those without trauma. “Depression and anxiety can promote a pro-inflammatory environment associated with chronic disease. If stress is persistent, it can lead to inflammation and adverse health consequences later in life. Thus, they get under the skin “, declared Kate Duchownylead author of the research. Additionally, the increase in traumatic events is linked to higher reports of moderate to severe pain (46%), fatigue (58%), dyspnea (46%), loneliness (12%), and low life satisfaction (73%) at the end of life.
Repeating a grade leaves lasting traces
According to the team, two in five volunteers experienced childhood trauma, such as getting into trouble with the police and being exposed to drug and alcohol abuse or physical violence from family members, especially parents. The most common potentially traumatic event in childhood was repeating a school year. The most common causes of trauma in adulthood were a life-threatening illness or having a spouse or child with a life-threatening illness. Less common causes were the death of a child, having a drug-addicted partner, surviving a natural disaster, or engaging in armed combat.
Faced with these data, the authors indicate that a trauma-informed approach to end-of-life care and the management of physical and psychosocial needs can improve a patient’s quality of life.