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. 2019 Sep 6:11:628-636.
doi: 10.1016/j.dadm.2019.07.006. eCollection 2019 Dec.

Incidence of mild cognitive impairment in World Trade Center responders: Long-term consequences of re-experiencing the events on 9/11/2001

Sean A P Clouston  1 , Erica D Diminich  1 , Roman Kotov  2 , Robert H Pietrzak  3   4 , Marcus Richards  5 , Avron Spiro 3rd  6   7   8 , Yael Deri  9 , Melissa Carr  10 , Xiaohua Yang  9 , Sam Gandy  11   12 , Mary Sano  12   13 , Evelyn J Bromet  2 , Benjamin J Luft  14
Affiliations

Incidence of mild cognitive impairment in World Trade Center responders: Long-term consequences of re-experiencing the events on 9/11/2001

Sean A P Clouston et al. Alzheimers Dement (Amst). .

Abstract

Objective: This study examined whether World Trade Center (WTC) exposures and chronic posttraumatic stress disorder (PTSD) were associated with incidence of mild cognitive impairment (MCI) in a longitudinal analysis of a prospective cohort study of WTC responders.

Methods: Incidence of MCI was assessed in a clinical sample of WTC responders (N = 1800) who were cognitively intact at baseline assessment. Crude incidence rates were calculated and compared to population estimates using standardized incidence ratios. Multivariable analyses used Cox proportional-hazards regression.

Results: Responders were 53.1 years old (SD = 7.9) at baseline. Among eligible cognitively intact responders, 255 (14.2%) developed MCI at follow-up. Incidence of MCI was higher than expected based on expectations from prior published research. Incidence was higher among those with increased PTSD symptom severity, and prolonged exposure was a risk factor in apolipoprotein-ε4 carriers.

Conclusions: PTSD and prolonged WTC exposures were associated with increased incidence of MCI in WTC responders, results that may portend future high rates of dementia in WTC-exposed responders.

Keywords: Mild cognitive impairment; Posttraumatic stress; World Trade Center disaster.

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Figures

Fig. 1
Fig. 1
Incidence proportion of mild cognitive impairment over time among responders, separated by PTSD symptom severity groups. PTSD symptom severity was categorized into low (0–0.249; 78.0% of the sample), medium (0.25–0.49; 15.5% of the sample), and high (0.50–1.00; 6.4% of the sample) in this figure. Abbreviation: PTSD, posttraumatic stress disorder.
Fig. 2
Fig. 2
Cumulative incidence proportion showing incidence of mild cognitive impairment among responders, separated by WTC exposure severity and by APOE-ε4 allele possession status group. Abbreviation: WTC, World Trade Center.
See this image and copyright information in PMC

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