Dementia Risk Higher in Veterans with PTSD

2010-09-02 22:04

It appears that the veterans returning from Iraq and Afghanistan who suffer with PTSD (post-traumatic stress disorder) may have another challenge to deal with: a higher risk of dementia. The increased risk of dementia was seen in veterans who served in previous wars as well, but will have serious implications for the soldiers serving in the current conflicts.

PTSD and Veterans

A recent Rand Corporation study reported that 300,000 service personnel who served in Iraq or Afghanistan had symptoms of PTSD. Symptoms of this disorder include avoiding people, things, or situations that remind an individual of the trauma he or she experienced, nightmares, mood disorders, sleep difficulties, flashbacks, difficulty maintaining close relationships, trouble with concentration, and more. People with PTSD can reach such a level of distress that they commit suicide.

The National Center for Posttraumatic Stress Disorder, which is part of the US Department of Veterans Affairs, notes that PTSD is believed to occur in about 30 percent of Vietnam veterans, up to 10 percent of Gulf War veterans, 6 to 11 percent of veterans of the Afghanistan war (Enduring Freedom), and 12 to 20 percent of veterans of the Iraq war (Iraqi Freedom).

The study involved 10,481 veterans who were at least 65 years of age who had been seen at the VA Medical Centre at least twice between 1997 and 1999. Outpatient data were collected until 2008. Subjects were classified based on whether they had been wounded during combat, with or without a PTSD diagnosis. A comparison group consisted of vets who had been seen at the Centre but who had no PTSD or combat-related injuries.

Senior author Mark Kunik, MD, MPH, a psychiatrist at the Michael E. DeBakey VA Medical Center in Texas, explained that “we found Veterans with PTSD had twice the chance for later being diagnosed with dementia than Veterans without PTSD.” The investigators have not identified the cause for the increased risk. However, Kunik noted that “it is essential to determine whether the risk of dementia can be reduced by effectively treating PTSD.”

Taking a closer look, the researchers found that 36.4 percent of the veterans in the study had PTSD. Of this group, 11.1 percent of them with PTSD who had not sustained combat injuries, and 7.2 percent of veterans with PTSD and injuries had dementia. These figures compared with 4.5 percent and 5.9 percent, respectively, with non-PTSD groups.

Kunik points out that understanding the relationship between PTSD and dementia “could have enormous implications for Veterans now returning from Iraq and Afghanistan.” Salah Qureshi, MD, psychiatrist and investigator with the Houston VA Center for Excellence, concurs, adding, “It will be important to determine which Veterans with PTSD are at greatest risk and to determine whether PTSD induced by situations other than war injury is also associated with greater risk.”

While war veterans with PTSD who appear to be at greater risk of dementia is a significant concern and challenge, the implications of this study extend beyond veterans to other individuals who have experienced traumatizing events and who may have PTSD. Further research is needed to clarify the relationship between dementia and PTSD for all affected populations.

SOURCES:
Mayo Clinic
National Center for Posttraumatic Stress Disorder
Qureshi SU et al. Journal of the American Geriatrics Society 2010 Sept; 58(9): 1627-33

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