老年退伍军人的战俘身份、创伤后应激障碍和痴呆。
Prisoner of war status, posttraumatic stress disorder, and dementia in older veterans.
机构信息
School of Medicine, University of Arizona, Tucson, AZ, USA.
Division of Geriatrics, Department of Medicine, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
出版信息
Alzheimers Dement. 2014 Jun;10(3 Suppl):S236-41. doi: 10.1016/j.jalz.2014.04.004.
BACKGROUND
It is not known whether prisoners of war (POWs) are more likely to develop dementia independently of the effects of posttraumatic stress disorder (PTSD).
METHODS
We performed a retrospective cohort study in 182,879 U.S. veterans age 55 years and older, and examined associations between POW status and PTSD at baseline (October 1, 2000-September 30, 2003), and incident dementia during follow-up (October 1, 2003-September 30, 2012).
RESULTS
A total of 484 veterans (0.3%) reported being POWs, of whom 150 (31.0%) also had PTSD. After adjusting for demographics, medical and psychiatric comorbidities, period of service, and the competing risk of death, the risk of dementia was increased in veterans who were POWs only (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.30-1.98) or had PTSD only (HR, 1.52; 95% CI, 1.41-1.64) and was greatest in veterans who were POWs and also had PTSD (HR, 2.24; 95% CI, 1.72-2.92).
CONCLUSIONS
POW status and PTSD increase risk of dementia in an independent, additive manner in older veterans.
背景
目前尚不清楚战俘（POW）是否更有可能在不受创伤后应激障碍（PTSD）影响的情况下患上痴呆症。
方法
我们对 182879 名年龄在 55 岁及以上的美国退伍军人进行了回顾性队列研究，并检查了基线（2000 年 10 月 1 日-2003 年 9 月 30 日）时 POW 身份和 PTSD 与随访期间（2003 年 10 月 1 日-2012 年 9 月 30 日）发生痴呆的相关性。
结果
共有 484 名退伍军人（0.3%）报告曾是战俘，其中 150 人（31.0%）也患有 PTSD。在调整了人口统计学、医疗和精神共病、服役期以及死亡的竞争风险后，仅作为战俘的退伍军人（风险比 [HR]，1.61；95%置信区间 [CI]，1.30-1.98）或仅患有 PTSD（HR，1.52；95% CI，1.41-1.64）以及同时患有 PTSD 和 PTSD 的退伍军人（HR，2.24；95% CI，1.72-2.92）患痴呆症的风险增加。
结论
战俘身份和 PTSD 以独立的、累加的方式增加了老年退伍军人患痴呆症的风险。
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