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Trauma and its consequences

in old age

Topic leader: Sjacko Sobczak

Please contact the topic leader if you would like to initiate new projects or have other ideas about global collaboration related to this topic. You can also directly submit your project proposal here.

1. ON TRAumatiC stress and ageing: a global networK (ON TRACK)

Project group

PI: Sjacko Sobczak

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 


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

Margherita Boltri, Sigmund Freud University, Milano, Italy

Liam Borelli-Millott, University of Melbourne, Australia

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

Gea van Dijk, NHL Stenden, The Netherlands

Ashley Dorame, Boston University, USA

Stéfanie Fréel, Amsterdam University Medical Centers, Amsterdam, The Netherlands

Barbara Forresi, Sigmund Freud University, Milano, Italy

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

Oj Jianqing, Singapore Institute of Technology (SIT), Singapore

Argyroukla Kalaitzaky, Hellenic Mediterranean University, Chania, Greece

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, Amsterdam, The Netherlands

Isadora Olive, UCL, Great Britain

Vasiliki Orgeta, UCL, Great Britain

Robert Pietrzak, Yale University, USA 

Conny Quaedflieg, Maastricht University, The Netherlands

Alyssa Reiner, University of Pennsylvania, USA

Jessica Ruisch, 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


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.



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.

Regular ON TRACK network meetings are taking place  Further plans and projects are being developed.


Would you like to participate the  ON TRACK network? Or do you have additional questions? Please contact: Sjacko Sobczak

1aON TRACK Position paper


Project group

PI : Sjacko Sobczak and ON TRACK network members



Several decades of research has shown that traumatic stress is associated with negative effects on the physical and mental health of older adults. Posttraumatic stress disorder (PTSD) is prevalent in older people, it accelerates the aging process and has been found to increase dementia risk. Despite the health and social care burden of living with trauma and PTSD in late life, including on older adults’ daily functioning and quality of life, systematic research into the prevalence, prognosis, and treatments for trauma and PTSD in older adults, as well as the mechanisms underlying trauma and ageing, remains limited.



The aim of the position paper is to strengthen and accelerate research on traumatic stress and ageing with efforts to improve prognosis and quality of life for older people affected by traumatic stress and PTSD. Increasing our knowledge on assessment and treatment will also improve recognition of PTSD and the development and evaluation of evidence-based treatments that will improve patient outcomes. Increasing knowledge on trauma and ageing mechanisms can further foster the development of more targeted and effective prevention programs. Specifically, this paper seeks to derive and report on evidence-based knowledge related to four domains: ageing mechanisms underlying trauma and ageing, progress in assessment and prevalence, and developments in care. The paper will also identify a specific call to action for future directions in research, clinical practice, and policy.


Current status

The paper is currently being drafted with planned submission in 2024. This paper may provide the basis for follow-on research, publications and projects.

For any questions or for more information, please contact: Sjacko Sobczak

References / Output 


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. 

Guo, J., Orgeta, V., Olivé, I., Hoff, E., Huntley, J., Olff, M., & Sobczak, S. (2024). Biomarkers associated with cognitive impairment in post-traumatic stress disorder: A systematic review of current evidence. Ageing Research Reviews, 102198.

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. 

National Center for PTSD. (2019). PTSD and Aging. PTSD Research Quarterly, No. 4. Retrieved from

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

Sobczak, S., van Kordenoordt, M., Uiterwijk, R., Cook, J. M., Havermans, D. C. D., Vossen, L., Ramakers, I., Olff, M., & van Alphen, S. P. J. (2024). Challenges in diagnosing Posttraumatic stress disorder in dementia: A case report. Psychiatry Research Case Reports, 3(1), 100207.

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2. TRAuma and DEmentia (TRADE)


Project group

PI: Sjacko Sobczak

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 



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.



The TRADE-project proposes to improve knowledge and clinical care for subjects suffering from both dementia and PTSD. Aims of the project include:

  1. Develop a valid diagnostic tool to diagnose PTSD and its severity in dementia subjects.

  2. Investigate the comorbidity rate of PTSD in dementia subjects living in clinical settings and care homes.

  3. 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.

  4. Investigate the effects on these parameters of EMDR-treatment.

  5. 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)


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. 


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)


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.



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)


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.


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






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