HIGHLIGHTS What is the primary question addressed by this study? This study investigated the change in depressive and trauma-related symptoms, physical activity levels, and alcohol consumption among older adults with chronic Posttraumatic stress disorder (PTSD). What is the main finding of this study? Despite possessing risk factors for adverse mental health consequences secondary to COVID-19, PTSD symptoms significantly declined among PTSD participants relative to trauma exposed healthy comparison subjects (TEs), and no group differences in loneliness, self-reported stress levels, or physical activity were observed. What is the meaning of the finding? These results raise interesting questions regarding to what extent the COVID-19 pandemic may function as a traumatic stressor capable of amplifying or re-triggering symptoms among individuals exposed to a different trauma type earlier in their lives. Catastrophic events may have different, less severe, pathologic implications when they occur on a global scale to all citizens as compared to when they occur to specific individuals or groups. It also is possible that resilience may be conferred on the basis of maturational changes in emotion processing, as older adults with PTSD may benefit from greater wisdom and more adaptive coping styles

Objective Failure to diagnose and treat post‐traumatic stress disorder (PTSD) may help explain the substantial disability, increased cognitive decline, and adverse health outcomes suffered by older adults with this disorder. To evaluate this possibility, we examined symptom differences among older and younger individuals with PTSD and measured the frequency with which older adults receive standard of care treatment. Methods Clinician‐Administered PTSD Scale for DSM (CAPS) scores were compared between younger and older adults with PTSD. Profiles were calculated for the most dominant CAPS symptom cluster reported by each participant, and the age cutoff best differentiating symptom clusters between individuals was determined. Clinical interview data (older adult sample only) were evaluated by trained raters to determine rates at which PTSD participants accessed treatment. Results Among 108 individuals with PTSD, 69% of participants <67 years old had Criterion C (avoidance) symptoms as the most dominant cluster compared to 39% of participants ≥67 (p = 0.016). Eight percent of participants <67 years had Criterion E (hyperarousal) symptoms as the most dominant cluster compared to 30% of participants ≥67 (p = 0.016). Less than 25% of the older adults (N = 53 subsample) were receiving a first‐line pharmacotherapy option for PTSD, and 0% of participants were currently participating in an evidence‐based psychotherapy for PTSD. Conclusions Clinicians evaluating patients should be aware that different symptom profiles may be present between younger and older adults with PTSD. Despite their high risk for adverse neuropsychiatric and other health consequences, older adults with PTSD appear to infrequently receive first‐line clinical treatment.