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Associations of post-traumatic stress disorder and metabolic syndrome with accelerated brain aging in South African adults: A case-control study.

October 9, 2026pubmed logopapers

Authors

Kim AW,Luckhoff H,du Plessis S,Seedat S

Affiliations (4)

  • Department of Anthropology, University of California, Berkeley, United States.
  • SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
  • Genomics of Brain Disorders Research Unit, South African Medical Research Council / Stellenbosch University, Cape Town, South Africa.

Abstract

Post-traumatic stress disorder (PTSD) and metabolic syndrome (MetS) are both associated with childhood trauma (CT) and accelerated brain aging. We examined the putative moderating effects of CT exposure on the associations of PTSD diagnosis and MetS status with brain aging in cases (n = 97) compared to trauma-exposed controls (n = 87). Brain age predictions were generated from T1-weighted magnetic resonance image scans using a pre-trained machine learning pipeline (brainageR). A measure of relative brain aging known as "predicted age difference" (PAD) was calculated by subtracting chronological age from the predicted brain age. Results showed that increased waist circumference was associated with a higher PAD, while CAPS-5 scores were associated with a lower PAD. MetS status was also associated with increased PAD in adults with lower CT exposure. The association between higher brain age difference scores and CT were more pronounced in participants with lower triglyceride levels. We found that increased waist circumference correlated with an increased PAD, independent of PTSD diagnosis. Future research should elucidate the possible mechanisms of accelerated brain aging and the protective factors that may slow its progression. Adults with post-traumatic stress disorder (PTSD) frequently develop metabolic syndrome (MetS), and scientists have found that people with either condition may exhibit similar patterns of neurodegeneration in certain regions of the brain - a process known as brain aging. This study examined the extent to which PTSD, MetS, the PTSD-MetS comorbidity, and childhood trauma were associated with brain aging. While PTSD, MetS, and its interaction were not related to brain aging patterns, we identified risk factors for accelerated brain aging, including greater waist circumference, MetS among adults with lower childhood trauma, and lower triglycerides among those with greater childhood trauma. These results demonstrate that developmental, metabolic, and cardiovascular risk factors may also pose increased risks for accelerated brain aging in adulthood.

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