Age differences in posttraumatic stress disorder, psychiatric disorders, and healthcare service use among veterans in Veterans Affairs primary care clinics.
OBJECTIVE
To expand our understanding of posttraumatic stress disorder (PTSD) prevalence, its psychiatric characteristics, and service use among elderly veterans in Veterans Affairs (VA) primary care clinics.


METHODS
A cross-sectional, epidemiological design (N = 745) incorporating self-report measures, structured interviews, and chart reviews was used to obtain relevant information for analyses.


RESULTS
The oldest group of veterans (>or=65 years; N = 318) had lower prevalence of most psychiatric diagnoses than the youngest (18-44 years; N = 69) and middle-aged (45-64 years; N = 358) groups. Despite having higher rates of combat exposure, veterans in the oldest group (6.3%) had one-third the prevalence of PTSD than those in the middle-aged group (18.6%). A similar pattern was found across other psychiatric diagnoses. For example, those in the oldest group (7.5%) had one-third the prevalence of major depression as those in the two younger groups (21.7% and 22.9%). These differences were maintained after controlling for relevant demographic covariates (race, sex). Results from examination of VA health care service use across the three groups were consistent with the findings that the oldest veteran group is functioning significantly better across mental health domains.


CONCLUSIONS
Elderly veterans who use VA primary care services evidence lower rates of PTSD and other psychiatric disorders, and they use significantly less VA mental health services. They also do not appear to show evidence of worse physical health functioning or use VA health care services or disability benefits at a meaningfully higher rate than their younger counterparts.
Department of Psychology, University of Hawaii at Hilo, Hilo, HI 96720, USA. frueh@hawaii.edu
B Christopher
BC
Frueh
Anouk L
AL
Grubaugh
Ron
R
Acierno
Jon D
JD
Elhai
Gregory
G
Cain
Kathryn M
KM
Magruder
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000407:Alabama; D003130:Combat Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013022:South Carolina; D014600:Utilization Review / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D014729:Veterans Disability Claims / Q000706:statistics & numerical data