Risk of neuropsychiatric symptoms among people who develop cognitive impairment with and without a history of post‐traumatic stress disorder

Abstract

AbstractBackgroundMost research studying the link between PTSD and cognitive impairment focuses on PTSD as a risk factor for developing Alzheimer’s disease; however, few studies focus on the impact cognitive impairment has on neuropsychiatric symptoms among people with a history of PTSD. Symptoms associated with cognitive decline may increase or cause the relapse of recurrent intrusive memories, dreams, or flashbacks of traumatic events among individuals with a history of PTSD. Additionally, cognitive impairment may lead to a delayed onset, worsening, or recurrence of PTSD‐related neuropsychiatric symptoms among people with PTSD. We aimed to prospectively assess the change in neuropsychiatric symptoms among people who develop cognitive impairment and have a history of PTSD.MethodData were obtained from the National Alzheimer’s Coordinating Center (NACC). Eligibility criteria included participants who were cognitively unimpaired and had non‐missing assessment of PTSD at initial visit, and who had at least one follow‐up visit with cognitive impairment. Information from the Uniform Data Set (UDS) health history and clinical diagnosis forms at the initial visit was used to separate participants with a history of (PTSD+) and participants without a history of (PTSD‐). Demographics, clinical symptoms, and mean NPI‐Q severity scores at the first UDS visit vs first visit with a Clinical Dementia Rating global score (CDR‐GS) of 0.5 were compared between groups.ResultThe final analytic sample included 18 PTSD+ participants and 585 PTSD‐ participants. While both groups experienced significantly higher mean NPI‐Q severity scores between baseline and the first visit with CDR‐GS = 0.5, there was not a significant difference between the groups (p = 0.79). Additionally, both groups exhibited significantly increased rates of change in NPI‐Q severity scores, but this rate was not statistically different between the groups (p = 0.73).ConclusionIn this sample, we found no differences in NPI‐Q scores. The small sample size of PTSD+ participants as well as the mild nature of participants’ cognitive impairment might account for these null findings, as it might be too mild to impact PTSD symptoms; as such, future research examining these symptoms in larger and more diverse samples is warranted.