A meta-analysis of cognitive functioning in older adults with PTSD

Schuitevoerder, Sage; Rosen, Jay; Twamley, Elizabeth W.; Ayers, Catherine R.; Sones, Heather M.; Lohr, James B.; Goetter, Elizabeth M.; Fonzo, Gregory A.; Holloway, Kathryn J.; Thorp, Steven R.

doi:10.1016/j.janxdis.2013.01.001

Cited by 156 publications

(106 citation statements)

References 51 publications

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“…The studies of dementia are consistent with many reports indicating worse cognitive performance in patients with PTSD. A recent meta-analysis conducted by members of the current research team revealed older adults with PTSD have greater than age-expected deficits in a range of cognitive domains, with particularly strong effects noted for processing speed, learning/memory, and executive functions (82). Note that these are also among the domains most commonly affected by normal aging (83).…”

Section: Discussionmentioning

confidence: 99%

Is Post-Traumatic Stress Disorder Associated with Premature Senescence? A Review of the Literature

Lohr

Palmer

Eidt

et al. 2015

The American Journal of Geriatric Psychiatry

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203

148

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Post-Traumatic Stress Disorder (PTSD) has major public health significance. Evidence that PTSD may be associated with premature senescence (early or accelerated aging) would have major implications for quality of life and healthcare policy. We conducted a comprehensive review of published empirical studies relevant to early aging in PTSD. Our search included the PubMed, PsycINFO and PILOTS databases for empirical reports published since the year 2000 relevant to early senescence and PTSD, including: (1) biomarkers of senescence (leukocyte telomere length (LTL) and pro-inflammatory markers), (2) prevalence of senescence-associated medical conditions, and (3) mortality rates. All six studies examining LTL indicated reduced LTL in PTSD (pooled Cohen’s d = 0.76). We also found consistent evidence of increased pro-inflammatory markers in PTSD (mean Cohen’s ds), including C-reactive protein = 0.18, Interleukin-1 beta = 0.44, Interleukin-6 = 0.78, and tumor necrosis factor alpha = 0.81. The majority of reviewed studies also indicated increased medical comorbidity among several targeted conditions known to be associated with normal aging, including cardiovascular disease, type 2 diabetes mellitus, gastrointestinal ulcer disease, and dementia. We also found seven of 10 studies indicated PTSD to be associated with earlier mortality (average HR = 1.29). In short, evidence from multiple lines of investigation suggests that PTSD may be associated with a phenotype of accelerated senescence. Further research is critical to understand the nature of this association. There may be a need to re-conceptualize PTSD beyond the boundaries of mental illness, and instead as a full systemic disorder.

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Section: Discussionmentioning

confidence: 99%

Is Post-Traumatic Stress Disorder Associated with Premature Senescence? A Review of the Literature

Lohr

Palmer

Eidt

et al. 2015

The American Journal of Geriatric Psychiatry

Self Cite

203

148

View full text Add to dashboard Cite

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“…Finally, this is the first known analysis to explore the relationship between alcohol use biomarkers and cognitive performance in veterans with comorbid problematic alcohol use and PTSD. Given several recent studies linking PTSD to cognitive dysfunction 51–53 , this high risk group could benefit from improved cognitive screening measures.…”

Section: Discussionmentioning

confidence: 99%

Association of Alcohol Use Biomarkers and Cognitive Performance in Veterans With Problematic Alcohol Use and Posttraumatic Stress Disorder: Data From the Mind Your Heart Study

Kalapatapu

Neylan

Regan

et al. 2014

Journal of Addictive Diseases

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We conducted a study of alcohol use biomarkers and cognitive performance among 85 veterans with problematic alcohol use and posttraumatic stress disorder (PTSD). All analyses were adjusted for demographics, depression, anxiety, and PTSD symptoms. Elevated levels of aspartate aminotransferase (AST) were associated with worse performance on the Trail Making Test Part A and Hopkins Verbal Learning Test. Two other biomarkers were not associated with any neurocognitive measures. Indirect alcohol use biomarkers (e.g., AST) may have a specific role in identifying those veterans with problematic alcohol use and PTSD who show a change in psychomotor speed and immediate verbal memory performance.

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“…Risk factors for CI and dementia include age, smoking, alcohol intake, cardiovascular disease, education, diabetes, and depression [4]. Research suggests that post‐traumatic stress disorder (PTSD) may also be associated with reduced cognitive functioning and increased risk of dementia [5,6]. PTSD involves complex memory, emotional, and behavioral processes [7], and encompasses distinct domains including re‐experiencing, effortful avoidance, emotional numbing, and hyperarousal resulting from a traumatic event [8].…”

Section: Settingmentioning

confidence: 99%

Cognitive impairment among World Trade Center responders: Long‐term implications of re‐experiencing the 9/11 terrorist attacks

Clouston

Kotov

Pietrzak

et al. 2016

Alz & Dem Diag Ass & Dis Mo

106

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IntroductionDuring the World Trade Center (WTC) attacks, responders who helped in search, rescue, and recovery endured multiple traumatic and toxic exposures. One-fifth subsequently developed post-traumatic stress disorder (PTSD). PTSD has been linked to dementia in veterans. This study examined the association between WTC-related PTSD and cognitive impairment (CI) in WTC responders.MethodsA one-third sample of responders (N = 818) reporting for annual monitoring visits were screened for cognitive impairment and dementia using the Montreal Cognitive Assessment from January 2014–April 2015. Concurrent diagnoses of PTSD and major depressive disorder (MDD), as well as serial PTSD and depressive symptom inventories, collected since 2002, were examined in relation to current CI.ResultsApproximately 12.8% and 1.2% of responders in this sample respectively had scores indicative of CI and possible dementia. Current PTSD and MDD were associated with CI. Longitudinal results revealed that re-experiencing symptoms were consistently associated with CI (aRR = 2.88, 95% confidence interval = 1.35–6.22), whereas longitudinal increases in other PTSD and depressive symptoms in the years before screening were evident only among those with CI.ConclusionsAnalyses replicated results from Veterans studies and further highlighted the importance of re-experiencing symptoms, a major component of PTSD that was consistently predictive of CI 14 years later. Clinicians should monitor CI when treating individuals with chronic PTSD.

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A meta-analysis of cognitive functioning in older adults with PTSD

Cited by 156 publications

References 51 publications

Is Post-Traumatic Stress Disorder Associated with Premature Senescence? A Review of the Literature

Is Post-Traumatic Stress Disorder Associated with Premature Senescence? A Review of the Literature

Association of Alcohol Use Biomarkers and Cognitive Performance in Veterans With Problematic Alcohol Use and Posttraumatic Stress Disorder: Data From the Mind Your Heart Study

Cognitive impairment among World Trade Center responders: Long‐term implications of re‐experiencing the 9/11 terrorist attacks

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