Greater Prevalence and Incidence of Dementia in Older Veterans with Posttraumatic Stress Disorder
Greater Prevalence and Incidence of Dementia in Older Veterans with Posttraumatic Stress Disorder
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DOI：
10.1111/j.1532-5415.2010.02977.x
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发表时间：
2010-09-01
影响因子：
6.3
通讯作者：
Kunik, Mark E.
中科院分区：
文献类型：
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作者：
Qureshi, Salah U.;Kimbrell, Timothy;Kunik, Mark E.
目的探讨老年退伍军人创伤后应激障碍（PTSD）与痴呆的关系。设计：在退伍军人事务医疗保健网络的一个区域部门内看到的个人的行政数据库研究。退伍军人综合服务网参与者65岁及以上诊断为PTSD或获得紫心勋章（PH）的退伍军人和年龄相同但未诊断为PTSD或PH的对照组被分为四组：有PTSD且无PH （PTSD+/PH-, n=3,660）、有PH且无PTSD （PTSD-/PH+, n=1,503）、有PTSD且有PH （PTSD+/PH+, n=153）和无PTSD或PH （PTSD-/PH-, n=5,165）。测量方法：在多因素logistic回归中控制混杂因素后，痴呆的发病率和患病率。结果PTSD+/PH-组痴呆的发病率和患病率均显著高于无PTSD（伴或不伴PH）组。在调整混杂因素后，PTSD+/PH-组痴呆的患病率和发病率仍是PTSD-/PH+或PTSD-/PH-组的两倍。其他组间无统计学差异。结论退伍军人PTSD患者痴呆的发生率和患病率较高。目前尚不清楚这是由于创伤后应激障碍和痴呆的共同危险因素，还是创伤后应激障碍是痴呆的危险因素。无论如何，这项研究表明患有创伤后应激障碍的退伍军人应该更密切地筛查痴呆症。由于创伤后应激障碍在退伍军人中很常见，因此这种联系对退伍军人护理具有重要意义。
OBJECTIVESTo explore the association between posttraumatic stress disorder (PTSD) and dementia in older veterans.DESIGNAdministrative database study of individuals seen within one regional division of the Veterans Affairs healthcare network.SETTINGVeterans Integrated Service Network 16.PARTICIPANTSVeterans aged 65 and older who had a diagnosis of PTSD or who were recipients of a Purple Heart (PH) and a comparison group of the same age with no PTSD diagnosis or PH were divided into four groups: those with PTSD and no PH (PTSD+/PH-, n=3,660), those with PH and no PTSD (PTSD-/PH+, n=1,503), those with PTSD and a PH (PTSD+/PH+, n=153), and those without PTSD or a PH (PTSD-/PH-, n=5,165).MEASUREMENTSIncidence and prevalence of dementia after controlling for confounding factors in multivariate logistic regression.RESULTSThe PTSD+/PH- group had a significantly higher incidence and prevalence of dementia than the groups without PTSD with or without a PH. The prevalence and incidence of a dementia diagnosis remained two times as high in the PTSD+/PH- group as in the PTSD-/PH+ or PTSD-/PH- group after adjusting for the confounding factors. There were no statistically significant differences between the other groups.CONCLUSIONThe incidence and prevalence of dementia is greater in veterans with PTSD. It is unclear whether this is due to a common risk factor underlying PTSD and dementia or to PTSD being a risk factor for dementia. Regardless, this study suggests that veterans with PTSD should be screened more closely for dementia. Because PTSD is so common in veterans, this association has important implications for veteran care.