title: Chronicity of posttraumatic stress disorder and risk of disability in older persons.
abstract: OBJECTIVE
  Little is known about the association between posttraumatic stress disorder (PTSD) and disability into later life. Most studies of late-life psychiatric disorders and function have focused on depression and generalized anxiety disorder.
  
  
  OBJECTIVE
  To determine the association between PTSD and disability among older adults and investigate if association differs by chronicity of PTSD.
  
  
  METHODS
  In total, 3287 participants 55 years and older (mean [SD] age, 66.0 [8.7] years, 60.1% women) involved in the Collaborative Psychiatric Epidemiology Surveys (2001-2003), including 3 aggregated, nationally representative studies (National Comorbidity Survey Replication, National Survey of American Life, and National Latino and Asian American Study). Analyses used weights and complex design-corrected statistical tests to infer generalizability to the US population.
  
  
  METHODS
  Disability defined by 5 domains (out of role, self-care, mobility, cognition, and social) using the World Health Organization Disability Assessment Schedule.
  
  
  RESULTS
  Of the 3.7% older adults who had a history of PTSD defined by DSM-IV criteria, 1.8% had persistent PTSD into later life (age of onset <55 years as well as a recent diagnosis). Frequency of any disability was 79.7% for persistent PTSD, 69.6% for pre-late life (age of onset <55 years and age at last diagnosis <55 years), and 36.9% for no PTSD (P < .001). In logistic regression analyses, adjusting for demographics, smoking, individual medical conditions, depression, generalized anxiety disorder, and substance use disorders, respondents with persistent PTSD were 3 times more likely to have any disability than were respondents with no PTSD (odds ratio, 3.18; 95% CI, 1.32-7.64). Global disability results were nonsignificant for pre-late life relative to no PTSD (odds ratio, 1.99; 95% CI, 0.97-4.08).
  
  
  CONCLUSIONS
  Disability in older Americans is strongly associated with PTSD, particularly PTSD that persists into later life. These findings suggest that monitoring and treatment of PTSD are important over the long term.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Byers
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Covinsky
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Neylan
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D014481:United States