Chronic Posttraumatic Stress Disorder and Comorbid Cognitive and Physical Impairments in World Trade Center Responders.
Chronic Posttraumatic Stress Disorder and Comorbid Cognitive and Physical Impairments in World Trade Center Responders.
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慢性创伤后应激障碍和共病的认知和身体障碍在世界贸易中心的反应。
DOI：
10.1002/jts.22631
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发表时间：
2021-06
影响因子：
3.3
通讯作者：
Luft BJ
中科院分区：
文献类型：
--
作者：
Diminich ED;Clouston SAP;Kranidis A;Kritikos M;Kotov R;Kuan P;Carr M;Bromet EJ;Luft BJ
创伤后应激障碍（PTSD）与认知和身体损伤的患病率和发病率增加有关。当合并症时，这些情况可能与不良的长期预后有关。我们研究了2001年9月11日恐怖袭击近20年后世界贸易中心（WTC）响应者慢性创伤后应激障碍与认知和身体功能症状域之间的关系。参与者包括2015-2018年参加监测计划的4,815名响应者的横截面样本。蒙特利尔认知评估得分低于23分提示认知障碍（CogI）；短物理性能电池在手部握力测试中得分为9分或更低表示物理损伤（PhysI）。共病性认知/身体障碍（Cog/PhysI）定义为至少有一项客观PhysI指标的认知障碍。临床图表回顾提供PTSD诊断；使用PTSD检查表评估症状域。参与者平均年龄53.05岁（SD = 8.01）；13.44%患有PTSD， 7.8%患有CogI， 24.8%患有PhysI， 5.92%患有Cog/PhysI合并症。多变量调整多项逻辑回归显示，应激障碍应答者发生Cog/PhysI的风险是应激障碍应答者的3倍以上（调整RR = 3.29, 95% CI 2.44‐4.44）。特定领域分析显示，情绪麻木症状预示着PhysI的风险增加（调整后的RR = 1.57, 95% CI 1.08‐2.28），而再次经历症状与Cog/PhysI共病相关（调整后的RR = 3.96, 95% CI 2.33‐6.74）。这些结果表明，慢性创伤后应激障碍的应答者在中年出现Cog/PhysI合并症的特征，可能会增加超出年龄预期的缺陷风险。
Posttraumatic stress disorder (PTSD) has been linked to increased prevalence and incidence of cognitive and physical impairment. When comorbid, these conditions may be associated with poor long‐term outcomes. We examined associations between chronic PTSD and symptom domains with cognitive and physical functioning in World Trade Center (WTC) responders nearly 20 years after the September 11, 2001, terrorist attacks. Participants included a cross‐sectional sample of 4,815 responders who attended a monitoring program in 2015–2018. Montreal Cognitive Assessment scores less than 23 indicated cognitive impairment (CogI); Short Physical Performance Battery scores 9 or lower on a hand‐grip test indicated physical impairment (PhysI). Comorbid cognitive/physical impairment (Cog/PhysI) was defined as having cognitive impairment with at least one objective PhysI indicator. Clinical chart review provided PTSD diagnoses; symptom domains were assessed using the PTSD Checklist. Participants were on average 53.05 years (SD = 8.01); 13.44% had PTSD, 7.8% had CogI, 24.8% had PhysI, and 5.92% had comorbid Cog/PhysI. Multivariable‐adjusted multinomial logistic regression demonstrated that Responders with PTSD have more than three times the risk of Cog/PhysI (adjusted RR = 3.29, 95% CI 2.44‐ 4.44). Domain‐specific analyses revealed that emotional numbing symptoms predicted an increased risk of PhysI (adjusted RR = 1.57, 95% CI 1.08‐2.28), whereas reexperiencing symptoms were associated with comorbid Cog/PhysI (adjusted RR = 3.96, 95% CI, 2.33‐6.74). These results suggest that responders with chronic PTSD may have increased risk of deficits beyond age‐expected impairment characterized by the emergence of comorbid Cog/PhysI at midlife.
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DOI：
10.1016/j.jalz.2017.04.014
发表时间：
2018-01
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
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作者：
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DOI：
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影响因子：
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作者：
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影响因子：
4.7
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通讯作者：
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影响因子：
2.1
作者：
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通讯作者：
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DOI：
10.1016/j.dadm.2019.01.003
发表时间：
2019-12-01
影响因子：
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作者：
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通讯作者：
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