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Objective This study aimed to examine the associations between age group, alcohol drinking status, and the development of posttraumatic stress disorder (PTSD) over a 2-year period in individuals who have sustained physical injuries.Methods Participants were consecutively recruited from a trauma center and prospectively followed for 2 years. At baseline, alcohol drinking status was assessed using consumption history and the Alcohol Use Disorders Identification Test (AUDIT). Age was categorized into younger (<60 years) and older (≥60 years) groups. A range of socio-demographic and clinical covariates were also collected. PTSD diagnosis during follow-up (3-, 6-, 12-, and 24-month post-injury) was established using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Binary and multinomial logistic regression analyses explored the relationships between alcohol drinking status, age group, and PTSD.Results Of 1,047 participants, 122 (11.7%) developed PTSD: 8.2% at 3 months, 7.2% at 6 months, 4.7% at 12 months, and 3.8% at 24 months. Younger age was significantly associated with PTSD. While alcohol use alone wasn’t linked to PTSD, it modified the age-PTSD relationship. This effect was weaker in hazardous drinkers (AUDIT ≥8) and stronger in low-risk drinkers (AUDIT <8), particularly at later follow-ups (6–24 months), but not at 3 months.Conclusion A significant alcohol-dependent association between age and PTSD highlights the need for targeted prevention strategies considering both alcohol use and age in physically injured individuals.

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