Reciprocal associations of posttraumatic stress symptoms and cognitive decline in community-dwelling older adults: The mediating role of depression

E. Cohn-Schwartz, Y. Hoffman, A. Shrira

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: People with posttraumatic stress disorder (PTSD) may have cognitive decline, a risk which can be particularly threatening at old age. However, it is yet unclear whether initial cognitive decline renders one more susceptible to subsequent PTSD following exposure to traumatic events, whether initial PTSD precedes cognitive decline or whether the effects are reciprocal. Objective: This study examined the bidirectional longitudinal associations between cognitive function and PTSD symptoms and whether this association is mediated by depressive symptoms. Method: The study used data from two waves of the Israeli component of the Survey of Health, Ageing, and Retirement in Europe (SHARE), collected in 2013 and 2015. This study focused on adults aged 50 years and above (N = 567, mean age = 65.9 years). Each wave used three measures of cognition (recall, fluency, and numeracy) and PTSD symptoms following exposure to war-related events. Data were analyzed using mediation analysis with path analysis. Results: Initial PTSD symptoms predicted cognitive decline in recall and fluency two years later, while baseline cognitive function did not impact subsequent PTSD symptoms. Partial mediation showed that older adults with more PTSD symptoms had higher depressive symptoms, which in turn were linked to subsequent cognitive decline across all three measures. Conclusions: This study reveals that PTSD symptoms are linked with subsequent cognitive decline, supporting approaches addressing this direction. It further indicates that part of this effect can be explained by increased depressive symptoms. Thus, treatment for depressive symptoms may help reduce cognitive decline due to PTSD.

Original languageEnglish
Pages (from-to)119-129
Number of pages11
JournalInternational Psychogeriatrics
Issue number2
StatePublished - 11 Feb 2024

Bibliographical note

Publisher Copyright:
© 2022 The Author(s). Published by Cambridge University Press on behalf of International Psychogeriatric Association.


This paper uses data from SHARE Waves 5 and 6 (DOIs: 10.6103/SHARE.w5.700, 10.6103/SHARE.w6.700). The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N°211909, SHARE-LEAP: GA N°227822, SHARE M4: GA N°261982), and Horizon 2020 (SHARE-DEV3: GA N°676536, SERISS: GA N°654221), and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged (see ).

FundersFunder number
National Institute on AgingP01_AG005842, Y1-AG-4553-01, OGHA_04-064, P30_AG12815, HHSN271201300071C, R21_AG025169, IAG_BSR06-11, U01_AG09740-13S2, P01_AG08291
Seventh Framework Programme261982, 211909, 227822
Sixth Framework ProgrammeCIT4-CT-2006-028812, RII-CT-2006-062193, CIT5-CT-2005-028857
Fifth Framework ProgrammeQLK6-CT-2001-00360
European Commission
Bundesministerium für Bildung und Forschung
Horizon 2020654221, 676536


    • PTSD
    • cognition
    • depressive symptoms
    • fluency
    • longitudinal
    • recall
    • warfare


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