Symptom profiles and treatment status of older adults with chronic post-traumatic stress disorder

Bret R. Rutherford, Sigal Zilcha-Mano, Marika Chrisanthopolous, Chloe Salzman, Carlen Zhu, Nicolas Cimino, Rachel Yehuda, Yuval Neria, Steven P. Roose

Research output: Contribution to journalArticlepeer-review


Objective: Failure to diagnose and treat post-traumatic stress disorder (PTSD) may help explain the substantial disability, increased cognitive decline, and adverse health outcomes suffered by older adults with this disorder. To evaluate this possibility, we examined symptom differences among older and younger individuals with PTSD and measured the frequency with which older adults receive standard of care treatment. Methods: Clinician-Administered PTSD Scale for DSM (CAPS) scores were compared between younger and older adults with PTSD. Profiles were calculated for the most dominant CAPS symptom cluster reported by each participant, and the age cutoff best differentiating symptom clusters between individuals was determined. Clinical interview data (older adult sample only) were evaluated by trained raters to determine rates at which PTSD participants accessed treatment. Results: Among 108 individuals with PTSD, 69% of participants <67 years old had Criterion C (avoidance) symptoms as the most dominant cluster compared to 39% of participants ≥67 (p = 0.016). Eight percent of participants <67 years had Criterion E (hyperarousal) symptoms as the most dominant cluster compared to 30% of participants ≥67 (p = 0.016). Less than 25% of the older adults (N = 53 subsample) were receiving a first-line pharmacotherapy option for PTSD, and 0% of participants were currently participating in an evidence-based psychotherapy for PTSD. Conclusions: Clinicians evaluating patients should be aware that different symptom profiles may be present between younger and older adults with PTSD. Despite their high risk for adverse neuropsychiatric and other health consequences, older adults with PTSD appear to infrequently receive first-line clinical treatment.

Original languageEnglish
Pages (from-to)1216-1222
Number of pages7
JournalInternational Journal of Geriatric Psychiatry
Issue number8
StatePublished - Aug 2021

Bibliographical note

Funding Information:
This study was supported by funding from National Institute of Mental Health (NIMH) R01 MH111596 (Rutherford) and R01 MH105355 (Neria).

Publisher Copyright:
© 2021 John Wiley & Sons Ltd.


  • dementia
  • phenomenology
  • post-traumaticstress disorder
  • treatment

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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