Lives in Transition: returning to civilian life with a physical injury or condition. Final report.
Executive Summary: This report presents the final findings of a project funded by Forces in Mind Trust (FiMT) called Understanding the transition to civilian life for ex-service personnel with physical conditions as a direct result of service or acquired whilst in service. Running from April 2019to October 2021, this project was the #rst substantive qualitative longitudinal research (QLR) to explore how service leavers experience the transition to civilian life when they have left the Armed Forces with a physical injury or condition. Despite the prevalence of physical conditions and injuries as a factor in leaving service, there is limited research that provides a holistic view of the experiences of this cohort. Our project was therefore structured to provide an exploration of the various stages of people’s journeys from injury/condition within service through to accessing civilian systems, support and employment.
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.