Understanding resilience as it affects the transition from the UK Armed Forces to civilian life
Abstract: In the years following the release of the UK Ministry of Defence’s (MOD) Armed Forces Covenant1 and Strategy for Veterans, there has been growing interest among policy officials, charity representatives and academic experts in understanding the transition process for Service leavers. While recent evidence suggests that resilience is important to successful transition, no systematic review has been undertaken on the subject of UK Service leaver resilience and transition prior to this study. To address this research gap, RAND Europe was commissioned by the Forces in Mind Trust (FiMT) to undertake a literature review comprised of a systematic review of academic literature, a Rapid Evidence Assessment (REA) of academic and grey literature, and a scoping review of ongoing research on UK Service leaver resilience and transition. This study aims to improve understanding of whether, and if so how, resilience can affect transition pathways and outcomes for UK Service leavers.
Abstract: Objectives: Increasing numbers of older adults are reentering community following incarceration (i.e., reentry), yet risk of incident neurodegenerative disorders associated with reentry is unknown. Our objective was to determine association between reentry status (reentry vs never-incarcerated) and mild cognitive impairment (MCI) and/or dementia. Methods: This nationwide, longitudinal cohort study used linked Centers for Medicare & Medicaid Services and Veterans Health Administration data. Participants were aged 65 years or older who experienced reentry between October 1, 2012, and December 31, 2018, with no preincarceration MCI/dementia, compared with age-matched/sex-matched never-incarcerated veterans. MCI/dementia was defined by diagnostic codes. Fine-Gray proportional hazards models were used to examine association. Results: This study included 35,520 veterans, mean age of 70 years, and approximately 1% women. The reentry group (N = 5,920) had higher incidence of MCI/dementia compared with the never-incarcerated group (N = 29,600; 10.2% vs 7.2%; fully adjusted hazard ratio [aHR] 1.12; 95% CI 1.00-1.25). On further investigation, reentry was associated with increased risk of dementia with or without prior MCI diagnosis (aHR 1.21; 95% CI 1.06-1.39) but not MCI only. Discussion: Transition from incarceration to community increased risk of neurocognitive diagnosis. Findings indicate health/social services to identify and address significant cognitive deficits on late-life reentry. Limitations include generalizability to nonveterans.