1. ON TRAumatiC stress and ageing: a global networK (ON TRACK)
Project group
PI: Sjacko Sobczak MD PhD
Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
E-mail: Sjacko.sobczak@maastrichtuniversity.nl
We are looking for expert volunteers with expertise in trauma and ageing in particular from underrepresented areas (non-Western) to join us.
Current network members
Marco Boks, Universitair Medisch Centrum Utrecht, The Netherlands
Erine Brocker, Stellenbosch University, South Africa
Lisa Brown, Palo Alto University, Florida USA
Monica Cations, Flinders University, Australia
Estelle Coeur, University Cote d’Azur, France
Joan Cook, Yale University, USA
Xavier Corveleyn, University Cote d’Azur, France
Eve Davison, Boston University School of Medicine, USA
Gea van Dijk, NHL Stenden, The Netherlands
Stéfanie Fréel, University Toronto, Canada
Ellen Gielkens, Mondriaan, The Netherlands
Mia Maria Günak, LMU Munich, Germany & UCL, Great Britain
Demi Havermans, Maastricht University, The Netherlands
Chris Hoeboer, Amsterdam University Medical Centers, The Netherlands
Bea Hollander-Goldfein, Transcending Trauma Project Philadelphia, USA
Malcolm Hopwood, University of Melbourne, Australia
Nancy Isserman, Transcending Trauma Project Philadelphia, USA
Oj Jianqing, Singapore Institute of Technology (SIT), Singapore
Karen Lawrence, University of Kentucky, USA
Lewina Lee, Boston University School of Medicine, USA
Andreas Maercker, University of Zurich, Switzerland
Julian MCKoy Davis, The University of the West Indies, Jamaica
Miranda Olff, Amsterdam University Medical Centers & ARQ National Psychotrauma Centre, The Netherlands
Isadora Olive, UCL, Great Britain
Vasiliki Orgeta, UCL, Great Britain
Robert Pietrzak, Yale University, USA
Conny Quaedflieg, Maastricht University, The Netherlands
Julia Schellong, Universität Dresden, Germany
Marjus Sela, Flinders University, Australia
Vanessa Simiola, Center for Integrated Health Care Research, Hawaii, USA
Sjacko Sobczak, Maastricht University, The Netherlands
Steven Thorp, Alliant International University, USA
Jelte Woudsma, UNO-UMCG, The Netherlands
Sedigheh Zabihi, UCL, Great Britain
Background
The global population is growing older and ageism takes place. Consequently, the number of people with dementia will also increase and is expected to double to 74.7 million by 2030 and more than triple by 2050. Several prospective studies have reported that the lifetime risks of dementia varied from 14.3% to 50% in different populations. The global costs of ageism and dementia are enormous and may be seen as a public health and social care priority worldwide.
Older adults and people with dementia may have a different symptom presentation of PTSD compared to adults. The prevalence of PTSD in these subgroups is estimated at respectively 3% and 4.7-7.8%. Possibly these are underestimations as older adults with PTSD may show a different and/ or blunted symptoms which may interfere with the clinical diagnostic process, in particular as cognitive dysfunctions are present.
The more as this last stage of life is in general a phase which is accompanied by loss experiences and feelings of impotence. All which may uncover traumatic memories and associated feelings and hence elicit (late-onset) PTSD.
Besides, PTSD has been associated with accelerated ageing and increased risk for dementia. But the long-term impact of traumatic stress on cognition and mental health in the ageing population and its determinants are insufficiently clear. Worldwide there are no collaborations of researchers who can advise clinical, social and health care policies.
Global collaborations between researchers in this area will strengthen and accelerate research on traumatic stress and its impact on ageing. An established network will aid in exchanging experience and knowledge. Consequently, efforts in this research field may be shared which will give a solid input to knowledge which is urgently needed in the current mondial ageing population. The ultimate goal is to improve prognoses for PTSD in older adults in general but also in those who are cognitive compromised such as in dementia. Proven and innovative prevention and treatment strategies can be evaluated in different settings in the care chain.
To improve global collaboration on this current topic, the Global Collaboration of Traumatic Stress is establishing a worldwide network of researchers in the field of traumatic stress, older adults and cognition.
Aims
The aim of ON TRACK network is to connect researchers worldwide who are working in the area of (mental) health care for older adults, care homes or who do research in the field of cognition (and its course) in relation to traumatic stress. Researchers who are active or interested in life-span research on the impact of traumatic stress are also invited. We want to share expertise, knowledge and experience and encourage future collaborations. Ultimately our aim of the network is to improve: i) knowledge on the impact of traumatic stress on ageing and neurodegeneration, ii) mental health prognosis for PTSD subjects over the whole life course.
Planning
The first ON TRACK network meetings have taken place in 2022. Further plans are being specified.
Contact
Would you like to participate the ON TRACK network? Or do you have additional questions? Please contact: Sjacko Sobczak (Sjacko.sobczak@maastrichtuniversity.nl)
References
Driessen, S., Ponds, R., van Alphen, B., Nederstigt A., Deckers, K. & Sobczak, S. (2023). Treating Symptoms of Posttraumatic Stress in People with Dementia: Expert Consensus Using the Delphi Method. Clinical Gerontologist. DOI: 10.1080/07317115.2023.2170842
Havermans, D. C., van Alphen, S. P., Olff, M., Van der Velden-Daamen, M., Verhey, F., Rutten, B. P., ... & Sobczak, S. (2022). The need for a diagnostic instrument to assess post-traumatic stress disorder in people with dementia: findings from a Delphi study. Journal of geriatric psychiatry and neurology, 08919887221103583. https://doi.org/10.1177/08919887221103583
van Dongen, D. H., Havermans, D., Deckers, K., Olff, M., Verhey, F., & Sobczak, S. (2022). A first insight into the clinical manifestation of posttraumatic stress disorder in dementia: a systematic literature review. Psychogeriatrics. https://doi.org/10.1111/psyg.12830
Sobczak, S., Olff, M., Rutten, B.P.F., Verhey, F., Deckers, K.. (2021). Comorbidity rates of posttraumatic stress disorder in dementia. European Journal of Psychotraumatology. 12 (1): 1-10. DOI: 10.1080/20008198.2021.1883923
National Center for PTSD. (2019). PTSD and Aging. PTSD Research Quarterly, No. 4. Retrieved from https://www.ptsd.va.gov/publications/rq_docs/V30N4.pdf
Cukor, J., Wyka, K., Jayasinghe, N., & Difede, J. (2010). The nature and course of subthreshold PTSD. Journal of Anxiety Disorders, 24(8), 918-923.
2. TRAuma and DEmentia (TRADE)
Project group
PI: Sjacko Sobczak MD PhD
Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
E-mail: Sjacko.sobczak@maastrichtuniversity.nl
Background
Studies on the comorbidity of PTSD in dementia are sparse, probably, because of the lack of a valid diagnostic tool. As subjects with dementia are often unable to give a valid report of their life history, in particular a delayed-onset PTSD may be easily missed. It is estimated that the comorbidity of PTSD in dementia is between 4.7- 7.8%.
Mondial the number of people with dementia are estimated at about 35.6 million in 2010 which is about to double every 20 years till approximately 115.4 million in 2050. Based on the suggested comorbidity rate of PTSD, number of affected subjects is substantial and will increase steadily in the coming years.
PTSD and dementia are both known for their impact on the quality of life of those affected. In clinical practice, we see that the combination of both causes significant psychological suffering. And that while it is precisely in people with dementia that the experiences of these violent events often revive. People with dementia and PTSD may live in constant fear and apprehension, and may be trapped in the re-experience of heavy events which may be paired with screaming and aggression. As the diagnosis of PTSD may be easily missed these neuropsychiatric symptoms are often described as ‘unexplained’ or ‘problem’ behavior. Effective proven treatment advices are missing.
The forthcoming global ageing population and related spate of dementia will urge us to improve care for these people.
Aims
The TRADE-project proposes to improve knowledge and clinical care for subjects suffering from both dementia and PTSD. Aims of the project include:
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Develop a valid diagnostic tool to diagnose PTSD and its severity in dementia subjects.
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Investigate the comorbidity rate of PTSD in dementia subjects living in clinical settings and care homes.
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Investigate the aimed population with respect to: neuropsychiatric symptoms and related behavioral problems, frailty and physical stress parameters, quality of life and health care burden and epigenetic profiles.
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Investigate the effects on these parameters of EMDR-treatment.
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Providing information and evidence to inform the development of policy and services for care of subjects with dementia and PTSD.
3. The lifetime prevalence and incidence of trauma exposure and PTSD among older adults: a systematic review
Project group
Monica Cations (Australia) (PI), Vasiliki Orgeta (UK), Sjacko Sobczak (Netherlands), Jean Stafford (UK), Marjus Sela (UK), Jelte Woudsma (Netherlands), Miranda Olff (Netherlands), Joan Cook (USA)
Background
Despite the significant impact of trauma on older adults’ physical and mental health estimates of the prevalence of lifetime trauma exposure among older adults remain poorly understood, with variation across studies.
Aims
The aim of this systematic review is to generate global estimates of the lifetime prevalence and incidence of exposure to psychologically traumatic events, lifetime PTSD, and current PTSD among adults aged 60 years and older.
4. Treatments for post-traumatic stress disorder in older adults: a systematic review of the evidence
Project group
Vasiliki Orgeta (UK) (PI), Sedigheh Zabihi (UK), Sjacko Sobczak (Netherlands), Joan Cook (USA), Ellen Gielkens (Netherlands), Miranda Olff (Netherlands), Conny Quaedflieg (Netherlands)
Background
Despite evidence that over 70% of older people are exposed to a potentially traumatic event during their lifetime, and reports that post-traumatic stress disorder (PTSD) affects over 7% of the population of older people, research in the clinical effectiveness of both pharmacological and non-pharmacological interventions such as psychological treatments, in treating PTSD symptoms continues to be limited.
Aims
The aim of the present review therefore is to examine the clinical-effectiveness of both pharmacological (i.e., venlafaxine, selective serotonin reuptake inhibitors) and non-pharmacological trauma-focused and non-trauma focused treatments (trauma-focused CBT, CBT, cognitive processing therapy, eye movement desensitisation and reprocessing), in reducing PTSD-related symptoms in older people. A secondary aim is to assess the quality of evidence and make recommendations for clinical guidelines worldwide.
5. The diagnostic accuracy of trauma and PTSD assessment in older adults: a systematic review
Project group
Karen Lawrence (USA), Demi Havermans (Netherlands), Estelle Coeur (France), O Jiaqing (Singapore), Joan Cook (USA), Sjacko Sobczak (Netherlands), Miranda Olff (Netherlands)
Background
While many assessment instruments are available for diagnosing PTSD in the general population, it is unclear which measures have strong psychometric properties (or are reliable and valid) among older adults. In order to enhance knowledge and accurate identification of PTSD in older adults, it is important to determine which instruments are available and have been validated in this population.
Aims
This systematic review aims to assess the diagnostic accuracy with respect to sensitivity and specificity of assessing trauma and PTSD among adults 60 years and older
