Cohort profile update: the US Millennium cohort study-evaluating the impact of military experiences on service members and Veteran health
Abstract: This paper provides an update to the original cohort profile paper published a decade ago. The Millennium Cohort Study is the largest, longest-running, prospective study of current and former United States (US) military personnel and is sponsored by the US Departments of Defense (DoD) and Veterans Affairs (VA). While the original study aim, evaluating the health impact of serving in the military, has remained consistent, the spectrum of research topics has expanded to include areas such as social determinants of health. 260 228 military personnel enrolled across 5 panels between 2001 and 2021 (baseline age range: 25-35 years); participants are surveyed every 3-5 years. The original 21-year follow-up period was extended through 2068 to examine health across the lifespan. Longitudinal survey data are linked to data from DoD, VA, and external sources (e.g. medical records, deployment histories, vital statistics, and geospatial data).
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.