The link between traumatic experiences and health in late life: challenges and opportunities for US-based longitudinal aging cohorts.

Abstract

Trauma, defined as exposure to actual or threatened death, serious injury, or sexual violence, is a pervasive, major public health challenge that disproportionately burdens socially disadvantaged groups and has known consequences for health outcomes in early and midlife. Despite plausible mechanisms by which trauma may also be a critically important risk factor for health outcomes in late life, there is presently a lack of literature evaluating the consequences of trauma on aging-related health outcomes and inequities, such as dementia. In this commentary, we (1) discuss drivers of the paucity of epidemiologic evidence on trauma and health outcomes in late life, namely a lack of available data, supported by detailed review of trauma measures, including interpersonal violence-a particularly common form of trauma-in 7 established longitudinal aging cohort studies in the United States; (2) address 4 common concerns about the inclusion of trauma measures in cohort studies; and (3) suggest ways forward, including specific assessment tools to measure interpersonal violence after a structured review of the PhenX Toolkit, to facilitate critical research to understand the impact of trauma on outcomes in late life.