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Post-Traumatic Stress Disorder Puts Older Veterans at Higher Risk for Dementia PTSD Could be Independent Dementia Risk Factor, Say Researchers
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Post-traumatic stress disorder (PTSD) is an anxiety disorder that can occur after exposure to life-threatening, traumatic, or fear-inducing situations. PTSD causes a cluster of symptoms, including re-experiencing, avoidance, difficulty falling or staying asleep, irritability or having outbursts of anger, difficulty concentrating, feeling constantly endangered, and being easily startled.
New Research in the Journal of the American Geriatrics Society
Veterans over the age of 65 who suffered PTSD were twice as likely to be diagnosed with dementia as were veterans without a PTSD diagnosis.
The study explored the relationship between PTSD and dementia in older veterans. Because PTSD and dementia share several risk factors, including traumatic brain injury, researchers suspected that veterans with PTSD would be at greater risk of dementia than veterans without PTSD. The researchers used Purple Heart status to denote veterans who had experienced combat-related physical injuries.
The study included 10,481 veterans, at least 65 years old, who had been seen at the VA at least twice between 1997 and 1999. Of those, 3660 were veterans without a Purple Heart who had been diagnosed with PTSD; 1503 had a Purple Heart but no PTSD diagnosis; 153 had PTSD and a Purple Heart, and 5156 had neither a Purple Heart nor PTSD.
The researchers discovered that 11.1% of the veterans with a PTSD diagnosis but no Purple Heart developed dementia, compared to 5.9% of the Purple Heart recipients without PTSD and 4.5% of the veterans without PTSD or a Purple Heart.
"Although most persons with PTSD will not develop dementia, those who have PTSD are much more likely to do so," said study author Mark E. Kunik, MD, MPH, associate director, Houston VA Health Services Research and Development Center of Excellence, associate director for research training, South Central MIRECC, and professor, Menninger Department of Psychiatry and Behavioral Sciences.
"This is an early finding and does not definitively establish that PTSD causes dementia. Ongoing studies that have followed Vietnam veterans for many years may help us to better understand the relationship," said Dr. Kunik. "We need to learn whether PTSD is the direct cause of dementia or whether those with PTSD share another risk factor."
He added, "We can't say from this study that getting treatment for PTSD decreases the likelihood for developing dementia, but we can say that the study provides one more good reason that people with PTSD should receive treatment."
Similar studies need to be performed in the civilian population to confirm this finding inindividuals suffering from PTSD caused by traumatic experiences other than combat.
"PTSD treatments that can effectively relieve psychological symptoms include medications and/or short-term talk therapy," said Dr. Kunik.
What Should I Do?
If you or a loved one has been diagnosed with PTSD, talk to your health care provider to make sure you're receiving appropriate treatment. If you have questions about dementia, talk to your provider and contact the Alzheimer's Association (www.alz.org) for more information.
The Summary above is from the full report titled, "Increased Prevalence and Incidence of Dementia in Older Veterans with Post-Traumatic Stress Disorder." It is in the September 2010 issue of the Journal of the American Geriatrics Society. The report is authored by Salah U. Qureshi, MD, Timothy Kimbrell, MD, Jeffrey M. Pyne, MD, Kathy M. Magruder, MPH, PhD, Teresa J. Hudson, PharmD, Nancy J. Petersen, PhD, Hong-Jen Yu, MS, Paul E. Schulz, MD, and Mark E. Kunik, MD, MPH.