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. 2020 Oct 1;71(10):998-1004.
doi: 10.1176/appi.ps.201900325. Epub 2020 Jun 10.

Increased Risk of Dementia Among Veterans With Bipolar Disorder or Schizophrenia Receiving Care in the VA Health System

Eileen P Ahearn  1 , Benjamin R Szymanski  1 , Peijun Chen  1 , Martha Sajatovic  1 , Ira R Katz  1 , John F McCarthy  1
Affiliations

Increased Risk of Dementia Among Veterans With Bipolar Disorder or Schizophrenia Receiving Care in the VA Health System

Eileen P Ahearn et al. Psychiatr Serv. .

Erratum in

  • Correction to Ahearn et al., 2020.
    [No authors listed] [No authors listed] Psychiatr Serv. 2020 Aug 1;71(8):879. doi: 10.1176/appi.ps.718correction1. Psychiatr Serv. 2020. PMID: 32741331 No abstract available.

Abstract

Objective: The Veterans Health Administration (VHA) provides a continuum of care over the life course. Among U.S. adults, bipolar disorder and schizophrenia are associated with increased risk of dementia. To inform service planning, this study assessed the incidence of dementia among veteran VHA patients with bipolar disorder or schizophrenia, with adjustment for comorbid medical conditions.

Methods: Using data from the VHA Corporate Data Warehouse, the authors identified all veterans who received VHA care in 2004 and 2005 without a dementia diagnosis and who were alive and between ages 18 and 100 as of January 1, 2006. Individuals were categorized as having bipolar disorder, schizophrenia, or neither condition on the basis of diagnoses in 2004-2005. Among ongoing VHA users, incidence of dementia was assessed for up to 10 years (2006-2015).

Results: The cohort included 3,648,852 individuals. After analyses controlled for baseline comorbid general medical conditions and substance use disorders, the incidence rate ratios (IRRs) for dementia were 2.92 for those with schizophrenia and 2.26 for those with bipolar disorder, compared with VHA patients with neither condition.

Conclusions: Among veterans receiving VHA care, diagnoses of bipolar disorder and schizophrenia were each associated with increased risk of receiving a new diagnosis of dementia, even when analyses controlled for baseline medical comorbidities. IRRs were elevated for patients with either condition, compared with those with neither condition, and highest for those with schizophrenia. VHA clinicians should evaluate patients for dementia when signs or symptoms of cognitive impairment are present.

Keywords: Bipolar disorder; Dementia; Schizophrenia; Veterans issues.

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Conflict of interest statement

Conflict of Interest: the authors report no conflict of interest

Figures

Figure 1.
Figure 1.
Incidence of dementia from 2006–2015 among Veterans who used Veterans Health Administration services in both 2004 and 2005, by diagnosis, gender, and age cohort. (SMI-serious mental illness, Schiz.- schizophrenia, PY-person years, M-men, F-women)
Figure 2.
Figure 2.
Survival curves for dementia for combined sample of men and women age 65–79 years (SMI-serious mental illness)
Figure 3.
Figure 3.
Survival curves for dementia for combined sample of men and women age 80–100 years (SMI-serious mental illness)
See this image and copyright information in PMC

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