Prisoner of war status, posttraumatic stress disorder, and dementia in older veterans
Prisoner of war status, posttraumatic stress disorder, and dementia in older veterans
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DOI：
10.1016/j.jalz.2014.04.004
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发表时间：
2014-06-01
影响因子：
14
通讯作者：
Barnes, Deborah E.
中科院分区：
文献类型：
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作者：
Meziab, Omar;Kirby, Katharine A.;Barnes, Deborah E.
背景：目前尚不清楚战俘是否更有可能独立于创伤后应激障碍(PTSD)的影响而患上痴呆。方法：我们对182,879名55岁及以上的美国退伍军人进行了一项回顾性队列研究，分析了战俘状况与基线(2000年10月1日至2003年9月30日)和随访期间(2003年10月1日至2012年9月30日)发生痴呆的关系。结果：共有484名退伍军人(0.3%)报告患有战俘，其中150人(31.0%)同时患有创伤后应激障碍。在调整了人口统计学、医疗和精神并发症、服役年限和相互竞争的死亡风险后，只有战俘的退伍军人(危险比[HR]，1.61；95%可信区间[CI]，1.30-1.98)或仅有创伤后应激障碍(HR，1.52；95%可信区间，1.41-1.64)的退伍军人患痴呆症的风险增加，而且在既是战俘又有创伤后应激障碍(PTSD)的退伍军人中风险最大(HR，2.24；95%CI，1.72-2.92)。结论：战俘状态和创伤后应激障碍以独立的、相加的方式增加老年退伍军人患痴呆的风险。(C)2014年，由爱思唯尔公司代表阿尔茨海默氏症协会出版。
Background: It is not known whether prisoners of war (POWs) are more likely to develop dementia independently of the effects of posttraumatic stress disorder (PTSD).Methods: We performed a retrospective cohort study in 182,879 U.S. veterans age 55 years and older, and examined associations between POW status and PTSD at baseline (October 1, 2000-September 30, 2003), and incident dementia during follow-up (October 1, 2003-September 30, 2012).Results: A total of 484 veterans (0.3%) reported being POWs, of whom 150 (31.0%) also had PTSD. After adjusting for demographics, medical and psychiatric comorbidities, period of service, and the competing risk of death, the risk of dementia was increased in veterans who were POWs only (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.30-1.98) or had PTSD only (HR, 1.52; 95% CI, 1.41-1.64) and was greatest in veterans who were POWs and also had PTSD (HR, 2.24; 95% CI, 1.72-2.92).Conclusions: POW status and PTSD increase risk of dementia in an independent, additive manner in older veterans. (C) 2014 Published by Elsevier Inc. on behalf of The Alzheimer's Association.