Cognitive Impairment Linked With PTSD, Depression Among World Trade Center Responders
A new study of workers who responded to the 2001 World Trade Center attacks displays an association between cognitive impairment and current posttraumatic stress disorder (PTSD) and depression.
Cognitive impairment was also associated over time with re-experiencing symptoms, such as flashbacks and nightmares, starting as early as 2002. The research has been published online by the journal Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring.
"To our knowledge, this is the first study to examine the association of PTSD and major depressive disorder (MDD) with cognitive impairment in a large group of civilian World Trade Center responders without head injury," said lead author Sean A. Clouston, PhD, Assistant Professor, Program in Public Health, Health Science Center, Stony Brook University in Stony Brook, New York.
Among the cohort of 818 responders, 104 participants, approximately 12.8%, had scores on a screening tool indicating cognitive impairment. Ten of the participants, 1.2%, exhibited possible dementia through their scores. Their average age at the time was 52.8 years old.
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The participants exhibiting cognitive impairment tended to have less education, occupations other than law enforcement, and older age, and were more likely to be current smokers, compared with those without cognitive impairment.
The research also found that the severity of re-experiencing symptoms at baseline was a predictor of subsequent diagnoses of PTSD and depression. One-fifth of the people who responded to the attacks have developed PTSD, the study’s authors said.
The research was part of the WTC Health Program, which is sponsored by the Centers for Disease Control and Prevention and has enrolled more than 33,000 responders since 2002 for research at five clinical centers.
"If our results are replicable, doctors need to be aware of the impact of cognitive impairment among individuals who have experienced traumatic events leading to PTSD,” Dr. Clouston said. “For example, cognitive impairment can compound the course of PTSD and depression, impairing the person beyond the impact of PTSD itself.”
Earlier research has linked PTSD with cognitive impairment in veterans, the authors pointed out. For example, a large study published in 2010 found the disorder was associated with a two-fold increase in the risk of incident dementia.
– Terri Airov
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