Evidence map›Paper›PMID 39353852›Full record

ArticleJournal of the American Geriatrics Society2025

The prevalence of lifetime trauma and association with physical and psychosocial health among adults at the end of life.

Kate A Duchowny, Alexander K Smith, Irena Cenzer, Chelsea Brown, Grace Noppert, Kristine Yaffe, Amy L Byers, Carla Perissinotto, Ashwin A Kotwal

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kate A DuchownySurvey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
Alexander K SmithDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Irena CenzerDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0002-5839-1070
Chelsea BrownDivision of Palliative Medicine, University of California, San Francisco, San Francisco, California, USA.
Grace NoppertSurvey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
Kristine YaffeSan Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
Amy L ByersDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Carla PerissinottoDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Ashwin A KotwalDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0002-6137-8512

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Louise C. Walter · 2013 to 2026
$19.9M
Loneliness and Social Isolation Among Older Adults with and without Alzheimer's Disease and Related Dementia in the Last Years of LifeK23AG065438 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KOTWAL, ASHWIN AJIT · 2020 to 2024
$809k
Social Disadvantage and Its Impact on Pathogen Burden and Immune Dysfunction Across the Life CourseR00AG062749 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI NOPPERT, GRACE A · 2021 to 2023
$747k
Examining the role of the neighborhood environment on muscle function in older adultsR00AG066846 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DUCHOWNY, CATHERINE · 2023 to 2025
$742k
Midcareer Investigator Award for Patient-Oriented Research in Dementia and Serious IllnessK24AG062785 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KELLEY, AMY STEVES · 2019 to 2022
$581k
CSRD Research Career Scientist Award ApplicationIK6CX002386 · VA · VETERANS AFFAIRS MED CTR SAN FRANCISCO · PI Amy Lynn Byers · 2022 to 2026
–
CSRD VA IK6 CX002386NIA NIH HHS K23 AG065438NIA NIH HHS K23AG065438NIA NIH HHS K24 AG062785NIA NIH HHS K24AG062785NIA NIH HHS P30 AG044281NIA NIH HHS P30AG044281NIA NIH HHS R00 AG062749NIA NIH HHS R00AG062749NIA NIH HHS R00 AG066846NIA NIH HHS R00AG066846
6 · The paper itself

Abstract

backgroundNational guidelines recognize lifetime trauma as relevant to clinical care for adults nearing the end of life. We determined the prevalence of early life and cumulative trauma among persons at the end of life by gender and birth cohort, and the association of lifetime trauma with end-of-life physical, mental, and social well-being.

methodsWe used nationally representative Health and Retirement Study data (2006-2020), including adults age > 50 who died while enrolled (N = 6495). Early life and cumulative traumatic events were measured using an 11-item traumatic events scale (cumulative trauma: 0-5+ events over the lifespan). We included six birth cohorts (born <1924; children of depression [1924-1930]; HRS cohort [1931-1941]; war babies [1942-1947]; early baby-boomers [1948-1953]; mid-baby boomers [1954-1959]). End-of-life outcomes included validated measures of physical (pain, fatigue, dyspnea), mental (depression, life satisfaction), and social (loneliness, social isolation) needs. We report the prevalence of lifetime trauma by gender and birth cohort and the adjusted probability of each end-of-life outcome by trauma using multivariable logistic regression.

resultsThe mean age at death was 78 years (SD = 11.1) and 52% were female. Lifetime trauma was common (0 events: 19%; 1-2: 47%; 3-4: 25%; 5+: 9%), with variation in individual events (e.g., death of a child, weapons in combat) by gender and birth cohort. After adjustment, increasing cumulative trauma was significantly associated (p-value<0.001) with higher reports of end-of-life moderate-to-severe pain (0 events: 46%; 1-2 events: 50%; 3-4 events: 57%; 5+ events: 60%), fatigue (58%; 60%; 66%; 69%), dyspnea (46%; 51%; 56%; 58%), depression (24%; 33%; 37%; 40%), loneliness (12%; 17%; 19%; 22%), and lower life satisfaction (73%; 63%; 58%; 54%).

conclusionOlder adults in the last years of life report a high prevalence of lifetime traumatic events which are associated with worse end-of-life physical and psychosocial health. A trauma-informed approach to end-of-life care and management of physical and psychosocial needs may improve a patient's quality of life.

Indexed as

Health StatusLife Change EventsTerminal CareAgedAged, 80 and overDepressionFemaleHumansMaleMiddle AgedPrevalenceUnited Statesend‐of‐lifelonelinesspainpalliative caretrauma

Identifiers

PMID39353852
PMCPMC11735274

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.