Affiliation:
1. The Jerusalem Institute of Aging Research, Hadassah Medical Center and Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel
2. Department of Geriatric Rehabilitation and the Center for Palliative Care, Hadassah Medical Center, Mount Scopus, and Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel
3. Brookdale Department of Geriatrics & Palliative Medicine Icahn School of Medicine at Mount Sinai & Honorary Attending in Medicine, Maimonides Health Brooklyn New York USA
Abstract
AbstractBackgroundHolocaust survivors (HS) alive today form a unique and disappearing population, whose exposure to systematic genocide occurred over 70 years ago. Negative health outcomes were widely documented prior to age 70. We examine the hypothesis that the experience of remote trauma continues to negatively affect health, functional status, and survival between the ages of 85–95.MethodsThe Jerusalem Longitudinal Study (1990–2022) followed a representative sample of Jerusalem residents born 1920–1921, at ages 85, 90 and 95. Home assessment included medical, social, functional, and cognitive status, and mortality data. Subjects were classified: (1) HS‐Camp (HS‐C): survived slave‐labor, concentration, or death camps; (2) HS‐Exposed (HS‐E): survived Nazi occupation of Europe; (3) Controls: European descent, outside Europe during WWII. We determined Hazards Ratios (HR), adjusting for gender, loneliness, financial difficulty, physical activity, ADL dependence, chronic ischemic heart disease, cancer, cognitive deficits, chronic joint pain, self‐rated health.ResultsAt ages 85 (n = 496), 90 (n = 524), and 95 (n = 383) the frequency of HS‐C versus HS‐E versus Controls was 28%/22%/50%, 19%/19%/62%, and 20%/22%/58%, respectively. No consistent significant morbidity differences were observed. Mortality between ages 85–90 and 90–95 years was 34.9% versus 38% versus 32.0%, and 43.4% versus 47.3% versus 43.7%, respectively, with no significant differences in survival rates (log rank p = 0.63, p = 0.81). Five‐year mortality adjusted HRs were insignificant for HS‐C and HS‐E between ages 85–90 (HR 0.87, 95% CI 0.54–1.39; HR 1.14, 95% CI 0.73–1.78) and ages 90–95 (HR 0.72, 95% CI 0.39–1.32; HR 1.38, 95% CI 0.85–2.23).ConclusionsSeventy years following their trauma and suffering during the Holocaust, the significant impairments of health, function, morbidity, and mortality which have accompanied survivors throughout their entire adult life, were no longer observed. Indeed, it is likely that survivors living >85 years old represent a uniquely resilient population of people, whose adaptation to adversity has accompanied them throughout their lives.
Subject
Geriatrics and Gerontology
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