Early Trauma Linked to More Pain and Loneliness at Life’s End

“What goes around, comes around,” we’re told since childhood. In a cruel twist on that adage, researchers have found that traumatic events early in life can return to haunt us later. A joint study from out of the Universities of California, San Francisco (UCSF), and Michigan exposes a connection between early-life trauma and greater pain, depression, and loneliness at the end of life.

The paper appears in the Journal of the American Geriatrics Society.

The research underscores the influential and lingering effects of childhood trauma – especially parental abuse – on one’s well-being later in life. 

“We found that early-life trauma in particular, especially physical abuse by parents, was strongly related to end-of-life pain, loneliness, and depressive symptoms,” senior author Ashwin Kotwal, MD, of the UCSF Division of Geriatrics and the San Francisco VA Medical Center said in a press release. “Traumatic events in childhood may have reverberating effects throughout the lifespan. They may play a role in social and emotional isolation, poor health habits, and an increased risk of subsequent trauma.”

Trauma Gets ‘Under the Skin’

The researchers worked with data from the Health and Retirement Study (HRS), which tracked more than 6,500 Americans 50 and older who died between 2006 and 2020. The study’s authors asked participants about their exposure to nearly a dozen different traumatic events. The researchers then evaluated the study participants’ psychosocial well-being before concluding with interviews with family members or close friends.

On the other hand, those who faced no trauma appeared to be less likely to experience such difficulties. They had a 46 percent likelihood of moderate-to-severe pain and a 12 percent probability of loneliness.

Kate Duchowny, PhD, first author of the study and a UM researcher, explained that trauma can have long-lasting biological consequences.

“Trauma ‘gets under the skin,’” she said. “We know that trauma is associated with depression and anxiety, which may promote a pro-inflammatory environment that is associated with chronic conditions. If stress is persistent, it can lead to inflammation and adverse health consequences in later life.”

Among the traumatic experiences participants recalled, repeating a school year was the most common during childhood. In early adulthood, life-threatening illnesses or having a loved one face such an illness emerged as the most common traumas.

Less common, but just as noteworthy, were events such as a child’s death, living through a natural disaster, or  – for veterans – facing combat.

More than 80 percent of the study’s participants had endured at least one traumatic event. And one-third had experienced three or more. Those with fewer traumas reported lower levels of end-of-life depression and anxiety, with just 24 percent of those with no traumas experiencing depression, compared to 40 percent of those who had faced five or more.

Following Up

The study’s authors advise that healthcare providers should approach end-of-life care through what they call a “trauma lens. Kotwal noted that the emotional and psychological dimensions of pain can be as important as the physical. He added that connecting with a psychologist or social worker could be crucial in easing one’s suffering.

For patients who’ve survived trauma, losing control over their body near the end of life can serve as a startling reminder of that earlier exposure.

Further Reading

Predictors of Loneliness by Age Decade

Remission of Psychotic Late-Life Depression Following ECT

Frailty and Mortality in Late-Life Depression