Dementia in Scottish military veterans: early evidence from a retrospective cohort study

Bergman, B. P., Mackay, D. F. and Pell, J. P. (2021) Dementia in Scottish military veterans: early evidence from a retrospective cohort study. Psychological Medicine, (doi: 10.1017/S0033291721002440) (PMID:34165055) (Early Online Publication)

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Abstract

Background: Few studies have examined whether UK military veterans are at an increased risk of dementia. We explored the risk of dementia in Scottish military veterans aged up to 73 years in comparison with people who have never served. Methods: Retrospective cohort study of 78 000 veterans and 253 000 people with no record of service, matched for age, sex and area of residence, with up to 37 years follow-up, using Cox proportional hazard analysis to compare risk of dementia in veterans and non-veterans, overall and by subgroup. Results: Dementia was recorded in 0.2% of both veterans and non-veterans overall, Cox proportional hazard ratio 0.98, 95% confidence interval (CI) 0.82–1.19, p = 0.879 (landmark age: 50 years), with no difference for men but increased risk in veteran women and Early Service Leavers. Post-traumatic stress disorder (PTSD) was associated with a higher risk of dementia in both veterans and non-veterans, although possibly to a lesser degree in veterans. A history of mood disorder was strongly associated with developing dementia, greater in veterans than in non-veterans, odds ratio 1.54, 95% CI 1.01–2.35, p = 0.045. Conclusions: There was no evidence to suggest that military service increased the risk of dementia, although this may change as the cohort ages. The well-documented association with PTSD shows no evidence of being stronger in veterans; by contrast, the association of mood disorder with dementia is much stronger in veterans. Healthcare providers should carefully assess the cognitive status of older veterans presenting with depressive illness in order to identify early dementia and ensure optimum management.

Item Type:Articles
Additional Information:This work was supported by a grant from the Forces in Mind Trust (grant number FiMT17/1101UG).
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pell, Professor Jill and Bergman, Dr Beverly and Mackay, Professor Daniel
Authors: Bergman, B. P., Mackay, D. F., and Pell, J. P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Psychological Medicine
Publisher:Cambridge University Press
ISSN:0033-2917
ISSN (Online):1469-8978
Published Online:24 June 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Psychological Medicine 2021
Publisher Policy:Reproduced under a Creative Commons License
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
302109Trends in Scottish Veterans' HealthBeverly BergmanForces in Mind Trust (FiMT) (FIMT)FiMT17/1101UGHW - Public Health