A recent study explored how cognitive performance, memory functions, and risk factors for Alzheimer’s disease correlate in veterans aged 65 and older who do not have dementia. The findings revealed various patterns of cognitive strengths and weaknesses, along with Alzheimer’s disease risk. The results suggest that older veterans experiencing specific cognitive issues might be erroneously diagnosed with potential Alzheimer’s disease when, in reality, other conditions, such as PTSD, could be the underlying cause of their cognitive challenges.
“PTSD consistently appears to be a significant factor in mild cognitive impairments, which indicates that Alzheimer’s disease might not always be the culprit in these cases among older veterans,” stated Dr. Kelsey R. Thomas, PhD, the lead researcher of the study. “This research has helped to reinforce the link between PTSD and cognitive difficulties in this group, providing us with a clearer direction for future investigations to better understand this association.”
The study also suggests that some Alzheimer’s disease screenings, which primarily focus on memory issues, might overlook older veterans who are at high risk of Alzheimer’s disease (as identified through PET scans showing high amyloid levels). More comprehensive assessments that include attention and executive functioning tests could identify these cognitive challenges more accurately.
“It’s common to diagnose cognitive impairment or dementia based on basic cognitive screenings or dementia rating scales. However, these might not capture all the necessary information that could influence treatment recommendations,” Dr. Thomas explained. “This underscores the importance of conducting thorough evaluations of older veterans, incorporating detailed cognitive assessments, clinical interviews, and when appropriate, biomarker tests for Alzheimer’s disease. Such approaches help us consider modifiable factors like PTSD, sleep quality, and pain, which can guide treatment recommendations and determine whether Alzheimer’s disease is a probable factor.”
The study categorised three groups of older veterans based on their self-reported cognitive decline, cognitive function tests (covering memory, language, and executive functions), and amyloid burden measured by PET scans. These groups were initially classified based on these criteria and then monitored over a year to observe overall cognition and daily functioning changes.
The findings highlight the need to re-evaluate how cognitive assessments and treatment options are considered for older veterans, advocating for more personalised approaches.
Driven by a commitment to enhance the lives of those who served, Dr. Thomas emphasises, “It’s crucial that we assist veterans in finding the most effective treatments. This research aims to highlight the need for care specifically tailored to older veterans’ needs.”
More information: Thomas, Kelsey R. et al, Cognition and Amyloid-β in Older Veterans: Characterization and Longitudinal Outcomes of Data-Derived Phenotypes, Journal of Alzheimer s Disease. DOI: 10.3233/JAD-240077
Journal information: Journal of Alzheimer s Disease Provided by IOS Press
