Posttraumatic stress disorder and health-related quality of life in pension-seeking Canadian World War II and Korean War veterans.

To the Editor: Studying the relationship between posttraumatic stress disorder (PTSD) and health-related quality of life (HRQoL) in older veterans is important, given these individuals’ high exposure to traumatic events during combat and their increasing health care needs due to advanced age, which may compound the already greater health care utilization and increased health costs associated with PTSD.1,2 Many factors can influence the susceptibility to PTSD among elderly veterans, including diminished functional and cognitive capacity and ongoing life stressors.3,4 Current stressors such as retirement or the death of a loved one may precipitate a worsening of PTSD, and, as this population of veterans ages, one can expect not only a worsening of HRQoL due to physical illnesses such as chronic cardiovascular diseases, but also an increase in claims for psychiatric illnesses related to service, such as PTSD.3,5 Although rates of PTSD in World War II and Korean War veterans were reported to be 7% to 9% in veterans who had never sought psychiatric treatment and as high as 37% to 80% in veterans in psychiatric treatment–seeking populations,6–13 research on PTSD and its impact on HRQoL in the elderly veteran population is lacking.14,15 The relationship between PTSD and HRQoL has been well established in younger combat veterans.16–22 The few studies that have focused on HRQoL in older veterans have demonstrated a decrease in HRQoL among individuals suffering from PTSD.21,23,24 The primary goal of this study was to examine the impact of PTSD on HRQoL impairment in older veterans, as well as the extent to which PTSD severity and depression, which is often comorbid with PTSD,25,26 predict HRQoL impairment. A secondary goal was to examine the relationship between HRQoL and the PTSD symptom clusters of reexperiencing, avoidance/numbing, and hyperarousal.