An evaluation and critical analysis of the impact of the Aged Veterans Fund
Abstract: There has been research on the numbers and needs of an ageing society yet, relatively little is known about the specific needs of older veterans, and the effectiveness of services specifically developed to meet these needs. In 2016 and 2017, the Armed Forces Covenant Fund Trust funded invested £30 million to the Aged Veterans Fund (AVF) programme. This consisted of 19 portfolio projects to support health, wellbeing, and social care needs for older veterans (born before 1st January 1950) and their families. This report explores the impact of the AVF, with the intent of informing service providers, stakeholders and policy makers, of the lessons learned and the next steps required for the support of older veterans. A retrospective evaluation focused on both the impact of the processes adopted by the programmes, and the outcomes achieved, was commissioned. Qualitative analysis was performed on 78 eligible source documents, from which 10 recurrent themes were identified.
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.