Holocaust survivors in old age: the Jerusalem Longitudinal Study.
OBJECTIVE
To examine the hypothesis that Holocaust exposure during young adulthood negatively affects physical aging, causing greater morbidity, faster deterioration in health parameters, and shorter survival.


METHODS
A longitudinal cohort study of the natural history of an age-homogenous representative sample born in 1920/21 and living in Jerusalem.


METHODS
Community-based home assessments.


METHODS
Four hundred fifty-eight subjects of European origin aged 70 at baseline and 77 at follow-up.


METHODS
Comprehensive assessment of physical, functional, and psychosocial domains; biographical history of concentration camp internment (Camp), exposure to Nazi occupation during World War II (Exposure), or lack thereof (Controls); and 7-year mortality data from the National Death Registry.


RESULTS
Holocaust survivors of the Camp (n=93) and Exposure (n=129) groups were more likely than Controls (n=236) to be male and less educated and have less social support (P=.01), less physical activity (P=.03), greater difficulty in basic activities of daily living (P=.009), poorer self-rated health (P=.04), and greater usage of psychiatric medication (P=.008). No other differences in health parameters or physical illnesses were found. Holocaust survivors had similar rates of deterioration in health and illness parameters over the follow-up period, and 7-year mortality rates were identical. Proportional hazard models showed that being an elderly Holocaust survivor was not predictive of greater 7-year mortality.


CONCLUSIONS
Fifty years after their Holocaust trauma, survivors still displayed significant psychosocial and functional impairment, although no evidence was found to support the hypothesis that the delayed effects of the trauma of the Holocaust negatively influence physical health, health trajectories, or mortality.
Stessman
Jochanan
J
Department of Geriatrics and Rehabilitation, Mount Scopus, Jerusalem, Israel.
Stesssman
Jochanan
J
Cohen
Aaron
A
Hammerman-Rozenberg
Robert
R
Bursztyn
Michael
M
Azoulay
Daniel
D
Maaravi
Yoram
Y
Jacobs
Jeremy M
JM
D000328:Adult; D000368:Aged; D000375:Aging / Q000208:ethnology / Q000502:physiology* / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D006304:Health Status; D017767:Holocaust; D006801:Humans; D007557:Israel; D007585:Jews / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D017741:Survivors / Q000523:psychology; D014947:Wounds and Injuries / Q000208:ethnology / Q000401:mortality* / Q000523:psychology*