Correlates of posttraumatic stress disorder among Veterans in the Canadian Longitudinal Study on Aging

LAY SUMMARY Little is known about the mental health of Veterans as they get older. How does the mental health and aging process of Veterans compare to people who have not served in the military? The Canadian Longitudinal Study on Aging (CLSA) is a long-term national study of the aging adult population in Canada. A total of 51,338 participants across Canada aged 45 to 85 years were recruited at the study baseline between 2011 and 2015. Of the CLSA participants, about 4,500 self-identified as Veterans, with military service dating back as early as 1941. The goal of this study was to describe the mental health, in particular posttraumatic stress disorder (PTSD), of Veterans in the CLSA at the study baseline and examine differences across Veteran sub-groups and compared to non-Veterans. Introduction: Research on mental health and posttraumatic stress disorder (PTSD) in the military is extensive. However, little Canadian research addresses this issue in Veterans released from military service decades earlier. This article describes correlates of PTSD among self-identified Veterans and non-Veterans in the Canadian Longitudinal Study on Aging (CLSA). Methods: CLSA sociodemographic, health, and military-related variables are compared among self-identified CLSA Veterans (Canadian Regular Force, Canadian Reserve Force, and non-Canadian) and non-Veterans. PTSD screening assessed symptoms in the past month. Correlates of PTSD screen were examined using multivariable logistic regression. Results: After age/sex adjustment, 7.6% of Regular Force Canadian Veterans, 4.9% of Reserve Force Canadian Veterans, 8.0% of non-Canadian Veterans, and 5.2% of non-Veterans screened positive for PTSD (PTSD+). From multivariable logistic regression, Canadian Regular Force Veterans were more likely to screen PTSD+ than non-Veterans (OR: 1.61, 95% CI: 1.29, 1.98) and Canadian Reserve Force Veterans (OR: 1.50, 95% CI: 1.02, 2.23). Among Veterans, younger age, retirement, multi-morbidity, depression, and self-reported anxiety were associated with increased odds of PTSD+. Discussion: Non-Canadian Veterans were most likely to screen positive for PTSD followed by Regular Force Canadian Veterans. Younger age, comorbidities, depression, self-reported anxiety, and service in the Canadian Regular Force were cross-sectionally associated with PTSD+. Being retired was associated with increased odds of PTSD+ only in Veterans. This study is a first step towards better understanding the relationships between age, PTSD, prior military service, and other covariates over time in a unique cohort of Veterans.