A Workshop on Cognitive Aging and Impairment in the 9/11-Exposed Population.

Robert D Daniels,Charles B Hall,Geoffrey M Calvert,Benjamin J Luft,Richard P Sloan,Tania Carreón,Caleb E Finch,Sam Gandy,Neil Vasdev,Elaine R Peskind,David A Bennett,Mary Sano,Marcus Richards,Avron Spiro,Travis L Kubale,Albeliz Santiago-Colón,Michelle M Mielke,Steven T Dekosky,Dori B Reissman,Erica D Diminich,Evelyn J Bromet,Murray A Raskind,Minos Kritikos,Sean Clouston ,William Charles Kreisl ,Kristi Anderson

doi:10.3390/ijerph18020681

Abstract

The terrorist attacks on 11 September 2001 potentially exposed more than 400,000 responders, workers, and residents to psychological and physical stressors, and numerous hazardous pollutants. In 2011, the World Trade Center Health Program (WTCHP) was mandated to monitor and treat persons with 9/11-related adverse health conditions and conduct research on physical and mental health conditions related to the attacks. Emerging evidence suggests that persons exposed to 9/11 may be at increased risk of developing mild cognitive impairment. To investigate further, the WTCHP convened a scientific workshop that examined the natural history of cognitive aging and impairment, biomarkers in the pathway of neurodegenerative diseases, the neuropathological changes associated with hazardous exposures, and the evidence of cognitive decline and impairment in the 9/11-exposed population. Invited participants included scientists actively involved in health-effects research of 9/11-exposed persons and other at-risk populations. Attendees shared relevant research results from their respective programs and discussed several options for enhancements to research and surveillance activities, including the development of a multi-institutional collaborative research network. The goal of this report is to outline the meeting’s agenda and provide an overview of the presentation materials and group discussion.

Highlights

The 11 September 2001 terrorist attacks on the World Trade Center (WTC) potentially exposed over 400,000 responders, workers, and residents to an array of psychological and physical stressors, as well as numerous potentially hazardous pollutants
This study found that 12.8% of participants had Montreal Cognitive Assessment (MoCA) scores indicating cognitive impairment, and approximately 1.2% suggesting dementia
This existing evidence is strongest for a potential link between chronic post-traumatic stress disorder (PTSD) and mild cognitive impairment (MCI) risk, environmental exposure to dust and particles that resulted from the collapse of the towers and subsequent cleanup activities cannot be ruled out as a contributing cause

Summary

Introduction

The 11 September 2001 terrorist attacks on the World Trade Center (WTC) potentially exposed over 400,000 responders, workers, and residents to an array of psychological and physical stressors, as well as numerous potentially hazardous pollutants. Unremitting and chronic symptoms of WTC-related post-traumatic stress disorder (PTSD) among individuals who experienced the attacks, or participated in the subsequent rescue, recovery and rehabilitation efforts may by causally associated with the development of MCI This pathway is supported by previous studies of combat veterans that found associations between PTSD and cognitive impairment [7,8]. This cause is supported by evidence suggesting that inhalation of air pollutants can increase the risk of neurodegenerative diseases [10,11,12,13,14,15,16,17]. Studies have found exposure–response associations between exposure to dust and debris from the collapsing towers and measures of cognitive functioning [2,3]

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