Background As older adults are prone to cognitive disorders, the interaction of the fields of substance use and misuse and cognitive neuroscience is an emerging area of research. Substance use has been reported in some subtypes of frontotemporal dementia (FTD), such as behavioral variant frontotemporal dementia (bvFTD). However, characterization of substance use in other subtypes of FTD, such as primary progressive aphasia (PPAPH), is unknown. Objective The objective of this baseline analysis was to explore whether any measures of substance use history differed significantly among bvFTD (n = 842) and PPAPH (n = 526) in a large national dataset. Design/Methods The National Alzheimer’s Coordinating Center’s (NACC) Uniform Data Set (UDS) study is a national dataset that collects data on patients with various cognitive disorders and includes some questions on substance use. We used each substance use variable as the outcome and the FTD subtype as the predictor. Results Total years smoked cigarettes, age when last smoked cigarettes, and average # of packs/day smoked when participants smoked, and any recent, remote, or combined recent/remote history of alcohol abuse or drug abuse did not significantly differ between the bvFTD and PPAPH subtypes (all p-values > 0.001). A significantly greater percentage of participants smoked in the last 30 days in the bvFTD subtype (10.4%, n = 834) compared to the PPAPH subtype (3.3%, n = 517) (p < 0.001). Discussion Clinical providers in both the dementia and substance use fields are encouraged to screen for and monitor substance use in all FTD subtypes.

Background It is not clear from prior studies whether trauma exposure predicts substance use problems independent of psychiatric comorbidities. Most prior studies were cross-sectional in nature, and none focused on prescription drug problems. Aims To address this gap in the literature, this paper is a secondary analysis of veterans from the Mind Your Heart prospective cohort study. The primary research question is whether trauma exposure predicts prescription drug problems even after controlling for major psychiatric symptoms, such as posttraumatic stress disorder and depression. Methods Multinomial logistic regression was used to assess whether the 10-item lifetime Brief Trauma Questionnaire (e.g., serious car accidents, war traumas, life-threatening illness, natural disasters, physical or sexual abuse) predicts prescription drug problems as determined by a self-report categorical question (3 answer choices) over a 4-year follow-up time period (n = 661 [100%] at year 1; 83.4% at year 2; 85.9% at year 3; 78.2% at year 4). Results Trauma exposure was positively associated with prescription drug problems in unadjusted and age-, sex-, and race-adjusted analyses at follow-up. After accounting for PTSD (PTSD Checklist-17 Civilian Version) and depression (Patient Health Questionnaire-9) symptoms, trauma exposure was no longer associated with prescription drug problems at all time points (relative risk ratios range 0.91–1.47). These results were robust to different missing data strategies. Discussion Trauma exposure was not associated with prescription drug problems over a 4-year follow-up in a prospective cohort study of veterans. Future directions include detailed measures of prescription drug problems and recruitment from community sites.