1. Military-related risk factors in female veterans and risk of dementia.
- Author
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Yaffe K, Lwi SJ, Hoang TD, Xia F, Barnes DE, Maguen S, and Peltz CB
- Subjects
- Aged, Aged, 80 and over, Brain Injuries complications, Brain Injuries, Traumatic complications, Cohort Studies, Dementia etiology, Depression complications, Female, Humans, Middle Aged, Risk Factors, Stress Disorders, Post-Traumatic complications, United States epidemiology, Veterans, Brain Injuries, Traumatic epidemiology, Dementia epidemiology, Depression epidemiology, Military Personnel, Stress Disorders, Post-Traumatic epidemiology
- Abstract
Objective: To determine whether diagnoses of traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and depression, alone or in combination, increase dementia risk among older female veterans., Methods: This cohort study included data from 109,140 female veterans ≥55 years of age receiving care from Veterans Health Administration medical centers in the United States between October 2004 and September 2015 with at least 1 follow-up visit. TBI, PTSD, depression, and medical conditions at study baseline and incident dementia were determined according to ICD-9-CM codes. Fine-Gray proportional hazards models were used to determine the association between military-related risk factors and dementia diagnosis, accounting for the competing risk of death., Results: During follow-up (mean 4.0 years, SD 2.3), 4% of female veterans (n = 4,125) developed dementia. After adjustment for demographics and medical conditions, women with TBI, PTSD, and depression had a significant increase in risk of developing dementia compared to women without these diagnoses (TBI-adjusted subdistribution hazard ratio [adjusted sHR] 1.49, 95% confidence interval [CI] 1.01-2.20; PTSD adjusted sHR 1.78, 95% CI 1.34-2.36; and depression-adjusted sHR 1.67, 95% CI 1.55-1.80), while women with >1 diagnosis had the highest risk for dementia (adjusted sHR 2.15, 95% CI 1.84-2.51)., Conclusions: We found that women with military-related risk factors had an ≈50% to 80% increase in developing dementia relative to women without these diagnoses, while female veterans with multiple risk factors had a >2-fold risk of developing dementia. These findings highlight the need for increased screening of TBI, PTSD, and depression in older women, especially female veterans., (© 2018 American Academy of Neurology.)
- Published
- 2019
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