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Study Suggests PTSD Associated with Cognitive Impairment Onset in 911 Responders

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STONY BROOK, NY, September 9, 2019 – Cognitive impairment with the potential for early onset dementia in 911 World Trade Center responders is continuing to be investigated by researchers monitoring the health of thousands of responders. A new study led by Stony Brook University that includes 1,800 responders reveals that post-traumatic stress disorder (PTSD) is strongly associated with onset of mild cognitive impairment (MCI). The study, published early online in Alzheimer’s & Dementia: Diagnosis, Assessment, and Disease Monitoring, also found that longer duration exposures working at Ground Zero results in an increased risk of cognitive impairment in individuals who carry a specific gene associated with dementia.

The findings build on a previous pilot study led by Sean Clouston, PhD, Associate Professor in the Department of Family Population and Preventive Medicine, Program in Public Health, and colleagues at the Renaissance School of Medicine at Stony Brook University. This study analyzed the cognitive health of responders treated and monitored for their health concerns at the Stony Brook World Trade Center Health and Wellness Program. Each had normal cognitive capacities at baseline in 2014 and 2015 followed by subsequent testing for cognitive decline.

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A study of 1,800 WTC responders reveals PTSD and longer duration exposure at Ground Zero is associated with cognitive impairment onset.

“One of the most concerning aspects of our findings is that we found a significant portion of responders have new onset cognitive impairment when many of them were cognitively normal within just the past few years,” says Clouston.

The average age of the responders was only 53 years at baseline testing when all had normal cognitive abilities and retention for their age. The study revealed that more than 14 percent of the responders had MCI at follow-up testing post baseline. The risk of MCI onset increased by 2.6 times among those who had higher PTSD symptom severity.

Tests used to gauge MCI in responders were completed in a manner consistent with the National Institute on Aging – Alzheimer’s Association definition of MCI. To avoid test and re-test biases that could vary neuropsychological testing results, alternate versions of the tests were used at each office visit.

Based on blood samples, the researchers also looked at the incidence of MCI in individuals who carry Apoliopoprotein-e4, which is associated with increased risks of dementia and is a marker for Alzheimer’s disease. They found that those who had the gene and had experienced long exposures working on the pile or pit at Ground Zero also had higher levels of newly experienced MCI.

Clouston emphasizes that future research regarding MCI and possible early dementia in 911 responders should focus on multifactorial risks, such as severity of PTSD symptoms and having one more other risk factors for dementia not related to their responder experience.

“This study underlies the increasingly apparent evidence that PTSD is not merely a psychological condition but also can have significant pathological effects on the brain and body,” says Benjamin Luft, MD, Director of the Stony Brook World Trade Center Health and Wellness Program, co-author and clinical lead of the study.

The research is supported in part by the National Institute of Health’s National Institute on Aging (Grant # AG049953) and the National Institute of Occupational Safety and Health.

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About Renaissance School of Medicine at Stony Brook University:

Established in 1971, Renaissance School of Medicine at Stony Brook University includes 25 academic departments. The three missions of the School are to advance the understanding of the origins of human health and disease; train the next generation of committed, curious and highly capable physicians; and deliver world-class compassionate healthcare. As a member of the Association of American Medical Colleges (AAMC) and a Liaison Committee on Medical Education (LCME) accredited medical school, Stony Brook is one of the foremost institutes of higher medical education in the country. Each year the School trains nearly 500 medical students and more than 600 medical residents and fellows. Faculty research includes National Institutes of Health-sponsored programs in neurological diseases, cancer, cardiovascular disorders, biomedical imaging, regenerative medicine, infectious diseases, and many other topics. Physicians on the School of Medicine faculty deliver world-class medical care through more than 31,000 inpatient, 108,000 emergency room, and 940,000 outpatient visits annually at Stony Brook University Hospital and affiliated clinical programs, making its clinical services one of the largest and highest quality medical schools on Long Island, New York. To learn more, visit www.medicine.stonybrookmedicine.edu.

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