A new study has found that early life and cumulative trauma are linked to poorer physical and psychosocial health at the end of life.
The report was published Tuesday in the Journal of the American Geriatrics Society.
Researchers used national data from the Health and Retirement Study from 2006 to 2020. It included details on 6,495 adults who were over the age of 50.
The team assessed early life and cumulative traumatic events using an 11-point scale. Participants with cumulative trauma had up to five events over their lives. The team also measured different age groups varying in different ranges to cover those born before 1924 to those born in 1959. The average age at death was 78 years old.
End-of-life outcomes were measured based on factors such as pain, fatigue, depression, and loneliness.
Among participants, 19% reported no trauma, while 47% experienced one to two traumatic events and 25% had three to four traumatic events. A total of 9% of people reported more than five traumatic events in their lives. Traumatic events could be everything from being hurt in combat to losing a child.
More cumulative trauma was significantly associated with higher reports of end-of-life moderate-to-severe pain, fatigue, not feeling like they could breathe, depression, loneliness, and lower life satisfaction.
Almost 40% of participants experienced trauma before 18 years of age, with 44% of men and 35% of women reporting early life trauma. Having a life-threatening illness was the most common traumatic event reported, occurring in 47% of men and 38% of women. For 87% of participants, these illnesses occurred within five years of their death.
Early life trauma, in particular, was strongly linked to people experiencing pain, loneliness and depressive symptoms at the end of their lives.
Overall, four in five older adults experienced at least one traumatic event and one in three experienced three or more events at any time in their lives, and the prevalence was comparable by age groups, gender, race and ethnicity, and socioeconomic status.
“Findings highlight the need for clinicians caring for seriously ill older adults to ensure interdisciplinary care for trauma symptoms and potentially adopting a trauma-informed approach to end-of-life care,” the authors wrote.
