A case-control study examining the association between service-related mental ill-health and dementia in male military veterans over the age of 65
Abstract: Dementia is currently incurable, irreversible and a major cause of disability for the world’s older population. The identification, and early intervention of modifiable risk factors, is therefore of increasing global priority. Prior scientific studies have suggested numerous risk factors which increase the chance of developing dementia, a number of which are suggested to occur at a greater frequency within military and military veteran personnel. One such risk factor is service-related mental ill health. This project aimed to determine whether service-related mental ill-health increases the risk that male military veterans have of developing dementia. The study compared the prevalence of service-related mental ill-health in male military veterans with dementia with those without dementia.
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.