Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring (Dec 2019)

Incidence of mild cognitive impairment in World Trade Center responders: Long‐term consequences of re‐experiencing the events on 9/11/2001

  • Sean A.P. Clouston,
  • Erica D. Diminich,
  • Roman Kotov,
  • Robert H. Pietrzak,
  • Marcus Richards,
  • Avron Spiro III,
  • Yael Deri,
  • Melissa Carr,
  • Xiaohua Yang,
  • Sam Gandy,
  • Mary Sano,
  • Evelyn J. Bromet,
  • Benjamin J. Luft

DOI
https://doi.org/10.1016/j.dadm.2019.07.006
Journal volume & issue
Vol. 11, no. 1
pp. 628 – 636

Abstract

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Abstract Objective This study examined whether World Trade Center (WTC) exposures and chronic posttraumatic stress disorder (PTSD) were associated with incidence of mild cognitive impairment (MCI) in a longitudinal analysis of a prospective cohort study of WTC responders. Methods Incidence of MCI was assessed in a clinical sample of WTC responders (N = 1800) who were cognitively intact at baseline assessment. Crude incidence rates were calculated and compared to population estimates using standardized incidence ratios. Multivariable analyses used Cox proportional‐hazards regression. Results Responders were 53.1 years old (SD = 7.9) at baseline. Among eligible cognitively intact responders, 255 (14.2%) developed MCI at follow‐up. Incidence of MCI was higher than expected based on expectations from prior published research. Incidence was higher among those with increased PTSD symptom severity, and prolonged exposure was a risk factor in apolipoprotein‐ε4 carriers. Conclusions PTSD and prolonged WTC exposures were associated with increased incidence of MCI in WTC responders, results that may portend future high rates of dementia in WTC‐exposed responders.

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