Considering many factors causing older veteran's cognitive difficulties may improve personalized care – EurekAlert

SAN DIEGO, CA Could 8, 2024 – A brand new examine investigated how measures of considering, reminiscence, and Alzheimer’s illness danger group collectively in Veterans aged 65 and older with out dementia. Outcomes of the examine confirmed a number of patterns of cognitive strengths and weaknesses and Alzheimer’s illness danger and should indicate that older Veterans with sure cognitive difficulties may mistakenly obtain a prognosis of attainable Alzheimer’s illness, when different components equivalent to PTSD might actually be the foundation reason behind the cognitive difficulties.

“PTSD appears to maintain rising as a key contributor to delicate cognitive difficulties, indicating that Alzheimer’s illness might not at all times be the reason for these difficulties in older Veterans,” mentioned Dr. Kelsey R. Thomas, PhD and Lead Researcher of the examine. “This examine helped to additional set up a connection between PTSD and cognitive difficulties in older Veterans, giving us larger understanding of subsequent steps to pursue to raised perceive this connection.”

Outcomes of the examine additionally indicate that sure screenings for Alzheimer’s illness that concentrate on reminiscence difficulties might in reality miss older Veterans at excessive danger for Alzheimer’s illness (decided by way of PET scans exhibiting excessive amyloid ranges), whereas extra complete exams would detect cognitive difficulties in consideration and govt functioning.

“It’s frequent to diagnose somebody with cognitive impairment or dementia primarily based on a cognitive screener or dementia ranking scale. Nonetheless, we could also be lacking different essential info that would affect remedy suggestions. This highlights the necessity for a radical analysis of older Veterans. A full scientific interview, extra detailed cognitive measures, and, if warranted, biomarker testing for Alzheimer’s illness will higher serve Veterans by understanding attainable modifiable components like PTSD, sleep, and ache to information remedy suggestions and to grasp if Alzheimer’s illness is a possible contributor.” Dr. Thomas mentioned.

Within the examine, three teams of older Veterans had been recognized primarily based on their subjective report of cognitive decline, measures of cognitive functioning (reminiscence, language, govt functioning) and amyloid burden measured utilizing a PET scan. Amyloid PET scans measure amyloid within the mind, which is linked to Alzheimer’s illness. Teams had been categorized at baseline utilizing these measurements after which the change within the teams on measures of world cognition and on a regular basis functioning over one yr was studied.

Three Teams (Baseline):

-Group one’s baseline knowledge indicated an average-to-above common cognition degree and low Alzheimer’s illness danger.

-Group two’s baseline knowledge confirmed difficulties with reminiscence and language however had a median danger of Alzheimer’s illness. Group two had the best charges of PTSD (54%), ache, and sleep difficulties.

-Group three’s baseline knowledge confirmed the bottom consideration/govt functioning. These cognitive difficulties had been associated to rapidly processing info and performing a cognitive switching activity (shifting consideration and inhibiting info). This group had the best danger for Alzheimer’s illness however had solely low common reminiscence perform.

After one yr:

-Group one confirmed little to no change in each on a regular basis functioning and international cognition.

-Group two confirmed a slight lower in on a regular basis functioning and, whereas their international cognition improved barely, they nonetheless maintained the bottom degree of world cognition.

-Group three confirmed the quickest charges of decline in each on a regular basis functioning and international cognition.

These outcomes have implications for re-evaluating how we assess and take into account remedy choices for older Veterans, particularly offering extra customized choices.

“As a result of group three did not present main reminiscence difficulties initially, they will not be thought of for Alzheimer’s illness remedy, though they confirmed excessive amyloid ranges (excessive danger for Alzheimer’s illness),” Dr. Thomas mentioned.

“If given solely a cognitive screening measure, Group two could be assumed to have Alzheimer’s illness given their low reminiscence scores and should not be appropriately labored up for PTSD, sleep difficulties, or ache. The truth is, these Veterans might not have Alzheimer’s illness and as a substitute PTSD and different components could also be the reason for their cognitive weaknesses,” Dr. Thomas mentioned.

She continued, “Excellent news is, these points are doubtlessly treatable.”

Her dedication to this analysis comes from a devotion to serving those that served.

“I care about giving Veterans a top quality of life as they age. It’s necessary that we assist Veterans discover a remedy that works greatest for them. With this analysis we hope to emphasise the necessity for individually tailor-made take care of older Veterans,” she mentioned.

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