Associations of Post-Traumatic Stress Disorder and Objective Subtle Cognitive Difficulties in Cognitively Unimpaired Older Veterans.

IF 2.1 4区心理学 Q2 PSYCHOLOGY Archives of Clinical Neuropsychology Pub Date : 2024-11-22 DOI:10.1093/arclin/acae058

Mary Ellen Garcia, Peter Rantins, Alin Alshaheri Durazo, Uriel Urias, Alexandra J Weigand, Katherine J Bangen, Mark W Bondi, Amy J Jak, Kelsey R Thomas

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Abstract

Introduction: Psychiatric conditions such as post-traumatic stress disorder (PTSD) and depression have a two-fold increased dementia risk in Veterans. Prior work has shown that psychiatric factors can both impact cognitive functioning and be early symptoms associated with Alzheimer's disease (AD). Objectively defined subtle cognitive difficulties (Obj-SCD) has been associated with cognitive decline and AD biomarkers. However, Obj-SCD has not yet been investigated in the context of psychiatric disorders.

Methods: A total of 179 cognitively unimpaired Veterans (50-92 years old) underwent a comprehensive neuropsychological evaluation at VA San Diego and a retrospective medical record review. Chi-squared tests compared rates of psychiatric diagnoses in Veterans with and without Obj-SCD.

Results: About 21% of the sample was classified as Obj-SCD. Relative to cognitively unimpaired Veterans, Veterans classified as Obj-SCD had higher rates of PTSD, but not higher rates of other psychiatric conditions (e.g., depression). The PTSD findings appear to be driven by measures of cognitive efficiency.

Conclusion: Elevated rates of PTSD, but not other psychiatric conditions, were observed among Veterans with Obj-SCD. The prevalence and type of subtle cognitive difficulties associated with PTSD in older Veterans demonstrates a need, and informs potential targets, for intervention. Further work is needed to determine mechanisms of subtle cognitive difficulties in older Veterans with PTSD.

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认知能力未受损的老年退伍军人中创伤后应激障碍与客观微妙认知困难的关联。

简介创伤后应激障碍（PTSD）和抑郁症等精神疾病会使退伍军人患痴呆症的风险增加两倍。先前的研究表明，精神因素既会影响认知功能，也会成为阿尔茨海默病（AD）的早期症状。客观定义的细微认知障碍（Obj-SCD）与认知能力下降和阿尔茨海默病生物标志物有关。然而，人们尚未在精神疾病的背景下对 Obj-SCD 进行研究：共有 179 名认知功能未受损的退伍军人（50-92 岁）在圣地亚哥退伍军人协会接受了全面的神经心理学评估和回顾性病历审查。通过卡方检验比较了有 Obj-SCD 和无 Obj-SCD 退伍军人的精神病诊断率：结果：约 21% 的样本被归类为 Obj-SCD。与认知能力未受损的退伍军人相比，被归类为 Obj-SCD 的退伍军人患创伤后应激障碍的比例较高，但患其他精神疾病（如抑郁症）的比例并不高。创伤后应激障碍的发现似乎是由认知效率的测量结果所驱动的：结论：在患有 Obj-SCD 的退伍军人中，创伤后应激障碍的发病率较高，但其他精神疾病的发病率并不高。在老年退伍军人中，与创伤后应激障碍相关的细微认知障碍的发生率和类型表明了干预的必要性，并为潜在的干预目标提供了信息。要确定患有创伤后应激障碍的老年退伍军人的细微认知困难的机制，还需要进一步的工作。

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来源期刊

Archives of Clinical Neuropsychology 医学-心理学

CiteScore

4.60

自引率

7.70%

发文量

358

审稿时长

6-12 weeks

期刊介绍： The journal publishes original contributions dealing with psychological aspects of the etiology, diagnosis, and treatment of disorders arising out of dysfunction of the central nervous system. Archives of Clinical Neuropsychology will also consider manuscripts involving the established principles of the profession of neuropsychology: (a) delivery and evaluation of services, (b) ethical and legal issues, and (c) approaches to education and training. Preference will be given to empirical reports and key reviews. Brief research reports, case studies, and commentaries on published articles (not exceeding two printed pages) will also be considered. At the discretion of the editor, rebuttals to commentaries may be invited. Occasional papers of a theoretical nature will be considered.