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.
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.
Authors: Charles W Hoge; Carl A Castro; Stephen C Messer; Dennis McGurk; Dave I Cotting; Robert L Koffman Journal: N Engl J Med Date: 2004-07-01 Impact factor: 91.245
Authors: J D Bremner; P Randall; T M Scott; R A Bronen; J P Seibyl; S M Southwick; R C Delaney; G McCarthy; D S Charney; R B Innis Journal: Am J Psychiatry Date: 1995-07 Impact factor: 18.112
Authors: K Yaffe; K Lindquist; B W Penninx; E M Simonsick; M Pahor; S Kritchevsky; L Launer; L Kuller; S Rubin; T Harris Journal: Neurology Date: 2003-07-08 Impact factor: 9.910
Authors: J D Bremner; T M Scott; R C Delaney; S M Southwick; J W Mason; D R Johnson; R B Innis; G McCarthy; D S Charney Journal: Am J Psychiatry Date: 1993-07 Impact factor: 18.112
Authors: Evgenia Gatov; Nicole Koziel; Paul Kurdyak; Natasha R Saunders; Maria Chiu; Michael Lebenbaum; Simon Chen; Simone N Vigod Journal: Can J Psychiatry Date: 2019-07-01 Impact factor: 4.356
Authors: Lotte Gerritsen; Hui-Xin Wang; Chandra A Reynolds; Laura Fratiglioni; Margaret Gatz; Nancy L Pedersen Journal: Am J Geriatr Psychiatry Date: 2017-03-16 Impact factor: 4.105
Authors: Allison R Kaup; Carrie Peltz; Kimbra Kenney; Joel H Kramer; Ramon Diaz-Arrastia; Kristine Yaffe Journal: J Int Neuropsychol Soc Date: 2016-10-04 Impact factor: 2.892
Authors: T W McGlennon; J N Buchwald; Walter J Pories; Fang Yu; Arthur Roberts; Eric P Ahnfeldt; Rukmini Menon; Henry Buchwald Journal: Obes Surg Date: 2020-10-30 Impact factor: 4.129