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Pivotal VA Study Finds Link between PTSD and Dementia

September 2, 2010

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"It will be important to determine which Veterans with PTSD are at greatest risk and to determine whether PTSD induced by situations other than war injury is also associated with greater risk," said Salah Qureshi, M.D., a staff psychiatrist and investigator with the Houston VA Center of Excellence and first author of the article.

HOUSTON – Results of a study reported in the September issue of the Journal of the American Geriatrics Society suggest that Veterans with post-traumatic stress disorder (PTSD) have a greater risk for dementia than Veterans without PTSD, even those who suffered traumatic injuries.

“We found Veterans with PTSD had twice the chance for later being diagnosed with dementia than Veterans without PTSD,” said Mark Kunik, M.D., M.P.H., a psychiatrist at the Michael E. DeBakey VA Medical Center and senior author of the article. “Although we cannot at this time determine the cause for this increased risk, it is essential to determine whether the risk of dementia can be reduced by effectively treating PTSD. This could have enormous implications for Veterans now returning from Iraq and Afghanistan.”

The study included 10,481 Veterans at least 65 years of age who had been seen at the VA at least twice during a two year period. Subjects who had received a Purple Heart (with and without a PTSD diagnosis) were also identified to provide a group with confirmed injuries and combat experience. A group with two visits, but no PTSD or Purple Heart, was identified for purposes of comparison. Outpatient data were gathered for all identified patients from 1997 through 2008.

“Despite the increased risk for those with PTSD, it is noteworthy that most Veterans with PTSD did not develop dementia during the period we studied,” said Salah Qureshi, M.D., a staff psychiatrist and investigator with the Houston VA Center of Excellence and first author of the article. “It will be important to determine which Veterans with PTSD are at greatest risk and to determine whether PTSD induced by situations other than war injury is also associated with greater risk.”

The authors note there could be several explanations for their findings. It could be that cognitive impairment in PTSD is an early marker of dementia, having PTSD makes one more likely to get dementia, or PTSD and dementia have some characteristics in common. They emphasize the need for further study with a broader sample in the civilian population.

Learning more about PTSD is currently a targeted goal of the Department of Veterans Affairs, as estimates of affected Veterans returning from Iraq and Afghanistan are as high as one in five. PTSD can have long-term consequences and affect individuals for many years after the combat experience. It is also associated with many of the same changes to memory and thinking as dementia.

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Awarded the Robert W. Carey Organizational Excellence Award in 2005, the Robert W. Carey Circle of Excellence Quality Award in 2007, and re-designation for Magnet Recognition for Excellence in Nursing Services in 2008, the Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 120,000 veterans in southeast Texas. Veterans from around the country are referred to the MEDVAMC for specialized diagnostic care, radiation therapy, surgery, and medical treatment including cardiovascular surgery, gastrointestinal endoscopy, nuclear medicine, ophthalmology, and treatment of spinal cord injury and diseases. The MEDVAMC is home to a Post Traumatic Stress Disorder Clinic; a Network Polytrauma Center; an award-winning Cardiac and General Surgery Program; a Liver Transplant Center; a VA Epilepsy Center of Excellence; a Health Services Research & Development Center of Excellence; a VA Rehabilitation Research of Excellence focusing on mild to moderate traumatic brain injury; and one of the VA’s six Parkinson’s Disease Research, Education, and Clinical Centers. Including the outpatient clinics in Beaumont, Conroe, Lufkin, Galveston, and Texas City, MEDVAMC outpatient clinics logged almost one million outpatient visits in fiscal year 2009. For the latest news releases and information about the MEDVAMC, visit www.houston.va.gov.