Post-traumatic stress disorder (PTSD) in mid-age and older adults differs by immigrant status and ethnicity, nutrition, and other determinants of health in the Canadian Longitudinal Study on Aging (CLSA)



This study aimed to address knowledge gaps about post-traumatic stress disorder (PTSD) in mid-age and older adults, with particular attention to the relationship of PTSD with nutrition and with ethnicity and immigrant status.


Binary logistic regression analysis of weighted comprehensive cohort data from the baseline Canadian Longitudinal Study on Aging (CLSA; n = 27,211) was conducted using the four-item Primary Care-PTSD tool (outcome) and immigrant status by ethnicity (Canadian-born white, Canadian-born minority, immigrant white, immigrant minority). Covariates included various social, economic, nutrition and health-related variables.


After controlling for socioeconomic and health variables, immigrants from minority groups had significantly higher odds of PTSD compared to their Canadian-born counterparts, whereas white immigrants had lower odds of PTSD. These relationships were significantly robust across seven cluster-based regression models. After adjusting for ethnicity/immigrant status, the odds of PTSD were higher among those earning lower household incomes, widowed, divorced, or separated respondents, ever smokers, and those who had multi-morbidities, chronic pain, high nutritional risk, or who reported daily consumptions of pastries, pulses and nuts, or chocolate. Conversely, those 55 years and over, who had high waist-to-height ratio, or who consumed 2–3 fiber sources daily had significantly lower odds of PTSD.


Interventions aimed at managing PTSD in mid-age and older adults should consider ethnicity, immigrant status, as well as socioeconomic, health, and nutrition status.

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Fig. 1



Adjusted odds ratio


Body mass index


Diagnostic and Statistical Manual of Mental Disorders, 4th Edition


Diagnostic and Statistical Manual of Mental Disorders, 5th Edition


Odds ratio


Primary Care Post-Traumatic Stress Disorder (scale)


Statistical Package for the Social Sciences


Bone density test score


Waist-to-hip ratio


Canadian Longitudinal Study on Aging


Post-traumatic stress disorder


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The authors wish to thank the CLSA National Coordinating Centre for providing the data for this analysis. This research was made possible using the data/biospecimens collected by the Canadian Longitudinal Study on Aging (CLSA). Funding for the Canadian Longitudinal Study on Aging (CLSA) is provided by the Government of Canada through the Canadian Institutes of Health Research (CIHR) under grant reference: LSA 9447 and the Canada Foundation for Innovation. This research has been conducted using the CLSA Baseline Tracking Dataset version 3.4 and Baseline Comprehensive Dataset version 4.0, under Application Number 170605. The CLSA is led by Drs. Parminder Raina, Christina Wolfson, and Susan Kirkland. We also wish to thank Mitacs Globalink Intern Jose Mora Almanza for his assistance with manuscript formatting (grant number: 17929).


Part of this study was funded through EFT’s Sandra Rotman Endowed Chair funds and KMD’s Fulbright Canada Research Chair funds.

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Correspondence to Esme Fuller-Thomson.

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Davison, K.M., Hyland, C.E., West, M.L. et al. Post-traumatic stress disorder (PTSD) in mid-age and older adults differs by immigrant status and ethnicity, nutrition, and other determinants of health in the Canadian Longitudinal Study on Aging (CLSA). Soc Psychiatry Psychiatr Epidemiol (2021).

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  • Older adults
  • Immigration
  • Ethnicity
  • Determinants of health
  • Nutrition
  • CLSA
  • Post-traumatic stress disorder
  • PTSD