Associations of TBI, PTSD, and depression with dementia risk among female military veterans: Not just men
Abstract: Over the past decade, it has become increasingly recognized that military veterans are at higher risk than the general population for neuropsychiatric conditions such as traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and depression. More recent work has shown an ≈2-fold increased long-term risk of dementia among predominantly male military veterans with TBI, PTSD, or depression compared to veterans without any neuropsychiatric conditions. However, the association of neuropsychiatric conditions with dementia among female military veterans is an important gap in the literature. More women are joining the military, and there is increasing evidence of sex differences in dementia risk in the general population.
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.