Luu Britney, Bangen Katherine J, Clark Alexandra L, Weigand Alexandra J, Rantins Peter, Garcia Mary Ellen, Urias Uriel, Merritt Victoria C, Thomas Kelsey R
VA San Diego Healthcare System, San Diego, CA, USA.
San Diego State University, San Diego, CA, USA.
Aging Ment Health. 2025 Feb;29(2):315-323. doi: 10.1080/13607863.2024.2389547. Epub 2024 Aug 8.
Post-traumatic stress disorder (PTSD) and subjective cognitive decline (SCD) are independent risk factors for Alzheimer's disease (AD) and dementia, but the association of their interaction on AD biomarkers have yet to be characterized. This study aimed to examine the impact of PTSD on the association between SCD and tau and amyloid positron emission tomography (PET) as well as global cognition in older Veterans.
This study included 87 Vietnam-Era Veterans without dementia (42 with PTSD; 45 without PTSD) from the Department of Defense-Alzheimer's Disease Neuroimaging Initiative. All participants had both tau and amyloid PET imaging as well as cognitive testing. SCD was measured using the Everyday Cognition questionnaire.
While SCD was associated with tau PET, amyloid PET, and global cognition, PTSD moderated these associations for tau and amyloid PET levels. Specifically, Veterans without PTSD had a stronger positive relationship between SCD and AD biomarkers when compared to those with PTSD.
Higher SCD was associated with greater tau and amyloid burden and worse cognitive performance across the sample, though the tau and amyloid associations were stronger for Veterans without PTSD. Results highlight the potential benefit of comprehensive clinical assessments including consideration of mental health among older Veterans with SCD to understand the underlying cause of the cognitive concerns. Additionally, more work is needed to understand alternative mechanisms driving SCD in older Veterans with PTSD.
创伤后应激障碍（PTSD）和主观认知衰退（SCD）是阿尔茨海默病（AD）和痴呆症的独立危险因素，但其相互作用与AD生物标志物之间的关联尚未得到明确。本研究旨在探讨PTSD对老年退伍军人中SCD与tau及淀粉样蛋白正电子发射断层扫描（PET）之间关联以及整体认知的影响。
本研究纳入了来自国防部阿尔茨海默病神经影像倡议的87名无痴呆症的越战时期退伍军人（42名患有PTSD；45名未患有PTSD）。所有参与者均接受了tau和淀粉样蛋白PET成像以及认知测试。使用日常认知问卷测量SCD。
虽然SCD与tau PET、淀粉样蛋白PET和整体认知相关，但PTSD调节了SCD与tau和淀粉样蛋白PET水平之间的这些关联。具体而言，与患有PTSD的退伍军人相比，未患有PTSD的退伍军人中SCD与AD生物标志物之间的正相关关系更强。
在整个样本中，较高的SCD与更大的tau和淀粉样蛋白负担以及更差的认知表现相关，尽管tau和淀粉样蛋白之间的关联在未患有PTSD的退伍军人中更强。结果强调了全面临床评估的潜在益处，包括考虑患有SCD的老年退伍军人的心理健康，以了解认知问题的潜在原因。此外，需要更多的研究来了解在患有PTSD的老年退伍军人中驱动SCD的其他机制。
