Articlegreen2010

Posttraumatic Stress Disorder and Risk of Dementia Among US Veterans

Kristine S. Yaffe · Eric Vittinghoff · Karla J. Lindquist · Deborah E. Barnes · Kenneth E. Covinsky · Thomas C. Neylan +2 more

595 citations0/0 files storedArchives of General Psychiatry

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Posttraumatic Stress Disorder Research Dementia and Cognitive Impairment Research Traumatic Brain Injury Research

Abstract

CONTEXT: Posttraumatic stress disorder (PTSD) is highly prevalent among US veterans because of combat and may impair cognition. OBJECTIVE: To determine whether PTSD is associated with the risk of developing dementia among older US veterans receiving treatment in the Department of Veterans Affairs medical centers. DESIGN: A stratified, retrospective cohort study conducted using the Department of Veterans Affairs National Patient Care Database. SETTING: Department of Veterans Affairs medical centers in the United States. PARTICIPANTS: A total of 181 093 veterans 55 years or older without dementia from fiscal years 1997 through 2000 (53 155 veterans with and 127 938 veterans without PTSD). MAIN OUTCOME MEASURES: During the follow-up period between October 1, 2000, and December 31, 2007, 31 107 (17.2%) veterans were ascertained to have newly diagnosed dementia according to International Classification of Diseases, Ninth Revision, Clinical Modification codes. RESULTS: The mean baseline age of the veterans was 68.8 years, and 174 806 (96.5%) were men. Veterans with PTSD had a 7-year cumulative incident dementia rate of 10.6%, whereas those without had a rate of 6.6% (P < .001). With age as the time scale, Cox proportional hazards models indicated that patients with PTSD were more than twice as likely to develop incident dementia compared with those without PTSD (hazard ratio, 2.31; 95% confidence interval, 2.24-2.39). After multivariable adjustment, patients with PTSD were still more likely to develop dementia (hazard ratio, 1.77; 95% confidence interval, 1.70-1.85). Results were similar when we excluded those with a history of head injury, substance abuse, or clinical depression. CONCLUSIONS: In a predominantly male veteran cohort, those diagnosed as having PTSD were at a nearly 2-fold-higher risk of developing dementia compared with those without PTSD. Mechanisms linking these important disorders need to be identified with the hope of finding ways to reduce the increased risk of dementia associated with PTSD.

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References

2004Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care 1990Trauma and the Vietnam War generation: report of findings from the National Vietnam Veterans Readjustment Study 1995MRI-based measurement of hippocampal volume in patients with combat- related posttraumatic stress disorder 2004Posttraumatic Stress Disorder and Physical Illness: Results from Clinical and Epidemiologic Studies 2006The Psychological Risks of Vietnam for U.S. Veterans: A Revisit with New Data and Methods

Cited by

2019Inflammation and post‐traumatic stress disorder 2010Returning Home from Iraq and Afghanistan 2014Traumatic stress, oxidative stress and post-traumatic stress disorder: neurodegeneration and the accelerated-aging hypothesis 2014Elevated Risk for Autoimmune Disorders in Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder 2011Childhood Trauma Associated with Short Leukocyte Telomere Length in Posttraumatic Stress Disorder 2017Oxidative Stress, Inflammation, and Neuroprogression in Chronic PTSD 2015Is Post-Traumatic Stress Disorder Associated with Premature Senescence? A Review of the Literature 2016A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression

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