Gielkens Ellen M J, Turksma Kim, Kranenburg Leonieke W, Stas Lara, Sobczak Sjacko, van Alphen Sebastiaan P J, Rossi Gina
Clinical center of excellence for older adults with personality disorders, Mondriaan Mental Health Center, Heerlen-Maastricht, The Netherlands.
Faculty of Psychology & Educational Sciences, Department of Psychology, Personality and Psychopathology Research Group (PEPS), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Clin Gerontol. 2025 Jan-Feb;48(1):37-47. doi: 10.1080/07317115.2022.2114397. Epub 2022 Sep 4.
Posttraumatic stress disorder (PTSD) after exposure to multiple (childhood) trauma's is strongly associated with accelerated aging and high psychiatric and somatic comorbidity, influencing frailty and Quality of Life (QoL) in older adults. Eye Movement Desensitization therapy (EMDR) addresses psychological and physiologic symptoms stemming from adverse life events and therefore could influence frailty and QoL in older adults.
We conducted a multi-center feasibility study (two psychiatric hospitals) in Dutch older outpatients (N = 24; ≥60 years) with PTSD. Participants received weekly EMDR-treatment during the course of the trial (3 months to a maximum of 9 months). Frailty (Groninger Frailty Indicator) and QoL (EuroQol 5D-3L), were assessed pre- and posttreatment.
A linear mixed-model approach showed significant reduction of frailty (F(1,23) = 9.019, p = .006) and improvement of QoL (F(1,23) = 13.787, p = .001). For both frailty and QoL, there was no significant influence of Clinician-Administered PTSD Scale (CAPS-5) pre-treatment score, therapy duration, and neither an interaction effect of therapy duration x CAPS-5 pre-treatment score.
EMDR with older adults with PTSD showed a significant reduction of frailty and improvement of QoL. Randomized controlled studies are needed to more precisely study the impact of trauma-focused treatment in older adults on frailty and QoL and the implications this might have for lessening disease burden.
Screening for PTSD in older frail adults is important to treat PTSD as a possible way to reduce frailty and improve QoL.
暴露于多种（童年）创伤后发生的创伤后应激障碍（PTSD）与加速衰老以及高精神和躯体共病性密切相关，会影响老年人的虚弱状态和生活质量（QoL）。眼动脱敏疗法（EMDR）可解决由不良生活事件引发的心理和生理症状，因此可能会影响老年人的虚弱状态和生活质量。
我们在荷兰的两家精神病医院对患有PTSD的老年门诊患者（N = 24；≥60岁）进行了一项多中心可行性研究。在试验过程中（3个月至最长9个月），参与者每周接受一次EMDR治疗。在治疗前后评估虚弱状态（格罗宁根虚弱指标）和生活质量（欧洲五维健康量表5D - 3L）。
线性混合模型方法显示虚弱状态显著降低（F(1,23) = 9.019，p = .006），生活质量得到改善（F(1,23) = 13.787，p = .001）。对于虚弱状态和生活质量，治疗前临床医生管理的PTSD量表（CAPS - 5）评分、治疗持续时间均无显著影响，治疗持续时间与CAPS - 5治疗前评分也没有交互作用。
对患有PTSD的老年人进行EMDR治疗显示虚弱状态显著降低，生活质量得到改善。需要进行随机对照研究，以更精确地研究针对老年人的创伤聚焦治疗对虚弱状态和生活质量的影响，以及这可能对减轻疾病负担产生的影响。
在体弱的老年人中筛查PTSD对于将治疗PTSD作为减轻虚弱状态和改善生活质量的一种可能方法很重要。
