SAN FRANCISCO (KCBS RADIO) - Traumatic experiences that happen to us early on can stick with us forever and worsen the pain, depression and loneliness we feel in our final days.
A new study led by UC San Francisco and the University of Michigan reveals that traumatic early-life experiences, such as childhood abuse and armed combat, can significantly impact physical and mental health at the end of life.
"Trauma can have these reverberating effects over the lifespan. And I think that's because it can get under our skin in different ways," Dr. Ashwin Kotwal, Geriatrics & Palliative Care physician at UCSF Health and senior author of the study, told KCBS Radio's Patti Reising on this week's episode of "As Prescribed."
"Things like being physically abused by their parents, having contact with the police, having to repeat a grade of school in kind of a traumatic or unforeseen way," Dr. Kotwal explained. "We also looked at traumatic events later in the lifetime, things like military exposures, if their spouse or children had a serious illness, if they ever had a child who died. These events we've seen clinically can really impact people's care when they're in the last months or years of their life."
The research findings, published in the Journal of the American Geriatrics Society, emerged from the Health and Retirement Study, which followed approximately 6,500 Americans over the age of 50, who died from 2006 to 2020. Four out of five people had at least one traumatic experience and nearly a quarter of people had four or more traumatic experiences over their lifetime.
"What was surprising to us was that trauma experienced earlier in life was linked to all sorts of different health needs, ranging from psychological needs like depression and life satisfaction, so how people kind of perceive their overall life satisfaction, to physical symptoms like pain, shortness of breath, even fatigue," said Dr. Kotwal.
Trauma early in life is also linked to social challenges at the end of life, with many people reporting loneliness -- perhaps because some losses they've experienced tend to linger on and become a part of who they are.
"We know that there are epigenetic changes or small changes to our DNA that can occur over people's lifetime, that can change how our immune systems function, how our inflammatory responses," Dr. Kotwal said. "We also know that trauma early in life can have psychological consequences throughout the lifetime, which might impact people's ability to get a good job, to their income, their ability to navigate other life stressors. So, it starts early and we need to be aware of that as people kind of progress throughout their lifetime."
Another thing that surprised the researchers is that the most common potentially traumatic event in childhood was repeating a school year.
"This was something that was common among many different generations, ranging from the baby movers to the silent generation," Dr. Kotwal said. "Some people might not consider it a traumatic event, but we think that it's at least a marker of a challenging childhood. And it's been shown to be an adverse childhood experience at the very least that's linked to other health conditions later in life."
The findings suggest that health care providers and caregivers should view a patient's needs through a "trauma lens."
"What that means is coming at challenges or challenging health needs with a lot of empathy, recognizing that life experiences may be contributing to what's going on, and also not stopping with just the medications or the kind of straightforward solutions," said Dr. Kotwal. "Think not just about individual diseases, but the whole person, what they're experiencing and what has led them up to this point."
Listen to this week's "As Prescribed" to learn more. You can also listen to last week's episode to hear about a a new UCSF clinic specializing in treating LGBTQ patients with IBD, here.
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“As Prescribed” is sponsored by UCSF.