Post Traumatic Stress Disorder and Risk of Dementia among U.S. Veterans
According to Yaffe et al. (2010), Post Traumatic Stress Disorder is a prevalent psychiatric syndrome linked to increased mortality and morbidity rates. This condition is among the most prevalent amid veterans returning from combat. Among veterans returning from Afghanistan and Iraq, the prevalence of post traumatic stress disorder is estimated to be about 17% (Seal et al., 2009). Veterans returning from Vietnam have a twenty to thirty percent rate. Past studies have confirmed that PTSD is linked to increased health care consumption and an augmented danger of developing a variety of other medical conditions among veterans such as dementia. The risk factors that link PTSD to increased rates of dementia include head injuries, depression or medical comorbidities.
This work highlights the findings of the study carried out by Yaffe et al. (2010). The project specifically focuses on the conclusions made by the researchers through ascertaining how the researchers presented, analyzed and interpreted their data to reach the conclusion. The reasoning procedure that led to the research conclusion of the researchers will be ascertained. This follows examinations of the research question and research objectives given that the two aspects are the most crucial factors of any research study. Particularly, the research questions guide the researcher in seeking for evidence and the explanation the researchers provide to the reader to promote their findings. This project also underlines the weaknesses of the researcher in providing their analysis and conclusions besides highlighting other probable conclusions that the researcher could have made based on their collected data. The project predominately explores the research findings presented by Yaffe et al. (2010), how well the researchers handled the research objectives, and what further study can be conducted to further develop the findings and conclusions of the study.
Kristine Yaffe; Eric Vittinghoff; Karla Lindquist; Deborah Barnes; Kenneth E. Covinsky; Thomas Neylan; Molly Kluse; Charles Marmar. Posttraumatic stress disorder and risk of dementia among us veterans. Arch Gen Psychiatry, 2010; 67 (6): 608-613.
The article, "Posttraumatic stress disorder and risk of dementia among U.S. veterans" written by Yaffe et al. (2010), explores the link between Post Traumatic Stress Disorder and dementia among older United States veterans obtaining treatment in the Department of Veterans Affairs medical centers. The underlying principle behind the article is the increased prevalence of PTSD among United States veterans that impairs their cognition. The researchers employed a stratified, retrospective cohort study that involved the Department of Veterans Affairs National Patient Care Database. The study involved 181,093 veterans aged beyond fifty-five years without any sign of dementia, 53, 155 veterans with dementia and 127-938 with Post Traumatic Stress Disorder. The findings from the study indicated that 17.2% of veterans seeking care from Veterans Affairs medical centers were diagnosed with dementia.
According to Yaffe et al. (2010), veterans suffering from PTSD had an increased rate of contracting dementia where the rate is placed at 10.6%. Veterans without PTSD had a rate of 6.6% of developing dementia. Patients with post traumatic stress disorder are twice likely to develop dementia compared to those without. The researchers concluded that veterans diagnosed with post traumatic stress disorder are at increased risk of developing dementia as opposed to veterans without PTSD. As a result, strategies connecting dementia and PTSD among veterans require investigation in efforts of seeking for means to lower the augmented danger of dementia linked to PTSD.
The study involved two groups of veterans, those with PTSD and those without. The researchers used two different groups in order to determine the link between post traumatic disorders and dementia among veterans returning from war. The qualities of the two different groups were put into comparison through t test for constant variables and x2 tests for definite variables. The incidence of dementia was sketched through the age of patients in the two groups. Cox proportional hazards were utilized to compare the age of occurrence of dementia among patients suffering from PTSD and those without the disease (Yaffe et al., 2010).To examine the effect of differential prospect for obtaining dementia diagnosis through absence or presence of PTSD, the researchers ran models shifting for a time-different covariate for the outpatients and inpatient visits at Veteran medical center on monthly basis. The researchers tested the proportional hazards postulation statistically and graphically for all the models. Stata statistical software, version 10.1 and SAS statistical software, version 9.1 were used to perform the analysis.
Following the data analysis, the results indicated that the total occurrence rates of dementia among veterans were considerably higher for veterans with post traumatic stress disorder compared to those without. Those with post traumatic stress disorder has a seven-year total occurrence rate of over 10% with occurrence dementia while veterans without post traumatic stress disorder had a seven-year rate of 6.6%. The occurrence of dementia rate was higher for veterans without PSTD. The occurrence of PTSD was linked to an increased danger of dementia among all subtypes of dementia (Qureshi et al., 2010). To assess whether veterans suffering from PTSD were at an augmented danger of developing dementia in absence of other psychiatric disorders, the researchers excluded veterans diagnosed with head injuries, substance abuse and clinical depression. Even after this procedure the results remained the same. The tests were repeated among the two groups and genders and the results remained the same. Male veterans diagnosed with PTSD depicted an augmented danger of dementia compared to males without PTSD.
According to the researchers, there are numerous reasons why PTSD patients demonstrate an augmented danger of developing dementia. Yaffe et al. (2010) assert that PTSD is linked to the development of dementia, and there is proof that veterans with PTSD do not perform well on cognitive tests. The poorer performance is a risk factor or development of dementia given that veterans with poor functions hold less cognitive reserve hence, augmented danger of cognitive impairment. Chronic stress also links PTSD to dementia as stress destroys the brain structure that is important for learning and memory. Past studies have demonstrated that patients suffering from PTSD hold smaller hioppocampal volumes linked to deficits in memory performance. Yaffe et al. (2010) assert that PTSD causes hippocampal atrophy, which augments cognitive deficits and dementia.
Yaffe et al. (2010) concluded that Post traumatic stress disorder is linked to the danger of dementia. As patients with PTSD age, the negative health conditions augment in frequency and as a result, patients with this disorder should be treated so as to lower the risk of negative health outcomes that include dementia. Patients with PTSD should also be screened for cognitive impairment to lower the risks of developing dementia.
The reasoning that led to the conclusion follows strict adherence to the objectives of the study. Although the researchers did not formulate a research question, their study was guided by their formulated objectives (Glasziou, Mar, & Salisbury, 2009). The main objective of the study was to determine the link between post traumatic stress disorder and dementia among veterans treated at VA facilities. The researchers also sought to understand whether the link between PTSD and dementia may be interpreted through clinical depression, medical comorbidities or head injury. The conclusions made by the researchers are sound given that they collected evidence-based data from patients' medical record. Their data is founded on practical research and not their own views. Evidently, the researchers consulted credible sources on the link between PTSD and dementia, but they did not perform clinical assessment to gather first-hand data from the patients.
Based on the evidence the researchers found, they concluded that patients with PTSD are twice at risk of developing dementia. Dementia is a chronic illness or constant disorder that affects mental disorders, and it is as a result of brain injury or disease. Dementia entails the persistent worsening of cognitive functions and the capacity to process ideas. The symptoms of this illness get worse gradually, and it is therefore important that intervention measures are put in place to address the illness and to prevent it (Qureshi et al., 2010). The research carried out by Yaffe et al. (2010) highlights the prevalence of dementia among veterans with post traumatic stress disorder, but the researchers failed to explore intervention and preventive measures to curb the effects of post traumatic stress disorder besides way to treat dementia.
While their research is an evidence-based research that assesses research findings, expert views to determine improvement methods and quality enhancement data, their findings do not close the gap between the prevalence of dementia among veterans with PTSD and the practice of nursing (Qureshi et al., 2010). As a result, the research does not offer means to apply relevant, valid and research-based data in decision-making (Pedro-Gormez, et al., 2012). This means that the researchers did not provide strategies to improve care of patient and enhance positive outcomes.
Yaffe et al.(2010) did not identify favorable patients upshots, but rather ascertained that mechanism connecting dementia and post traumatic disorder need to determined to seek means of reducing the augmented danger of…