Dementia in military and veteran populations: a review of risk factors\u2014traumatic brain injury, post-traumatic stress disorder, deployment, and sleep

Zara Raza,Russell G Foster,Nick Caplin,Renata S M Gomes,Gershon Spitz,Syeda F Hussain,Suzanne Ftouni

doi:10.1186/s40779-021-00346-z

Zara Raza, Russell G Foster + Show 5 more

Open Access

https://doi.org/10.1186/s40779-021-00346-z

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Abstract

The military population face a unique set of risk factors that may increase the risk of being diagnosed with dementia. Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) have a higher prevalence in this group in comparison to the civilian population. By delving into the individual relationships between TBI and dementia, and PTSD and dementia, we are able to better explore dementia in the military and veteran populations. While there are some inconsistencies in results, the TBI-dementia association has become more widely accepted. Moderate-to-severe TBI has been found to increase the risk of being diagnosed with Alzheimer’s disease. A correlation between PTSD and dementia has been established, however, whether or not it is a causal relationship remains unclear. Factors such as blast, combat and chemical exposure may occur during a deployment, along with TBI and/or PTSD diagnosis, and can impact the risk of dementia. However, there is a lack of literature exploring the direct effects of deployment on dementia risk. Sleep problems have been observed to occur in those following TBI, PTSD and deployment. Poor sleep has been associated with possible dementia risk. Although limited studies have focused on the link between sleep and dementia in military and veteran populations, sleep is a valuable factor to study due to its association and interconnection with other military/veteran factors. This review aims to inform of various risk factors to the cognitive health of military members and veterans: TBI, PTSD, deployment, and sleep.

Highlights

It was estimated that in 2020, there were 5.8 million people aged 65 years and over living with the Alzheimer’s sub-type of dementia in the United States (U.S.) [1]
Military deployment, Traumatic brain injury (TBI), post-traumatic stress disorder (PTSD) and poor sleep might all contribute to dementia development in military and veteran populations, with differing measures of impact (Fig. 1)
The link between TBI and dementia appears to be the strongest from the current literature reviewed, with moderate-to-severe TBI increasing the risk of dementia development

Summary

Introduction

It was estimated that in 2020, there were 5.8 million people aged 65 years and over living with the Alzheimer’s sub-type of dementia in the United States (U.S.) [1]. This estimated value is based on American census data from 2010 and a population study that looked at chronic. Raza et al Military Med Res (2021) 8:55 This is the age range that is at greatest risk of developing dementia, and this risk is compounded by the fact that veterans face a unique set of risk factors such as traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Alzheimer’s disease (AD) is the most common form of dementia and this is reflected in the reviewed literature, with frontotemporal dementia (FTD), Parkinson’s disease dementia, dementia with Lewy bodies and vascular dementia discussed

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