scholarly journals THE ASSOCIATION OF MILD TBI WITH EARLY ONSET DEMENTIA IN POST-9/11 VETERANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S657-S657
Author(s):  
Mary Jo Pugh ◽  
Hari Krishna Raju Sagiraju ◽  
Blessen Eapen ◽  
Alicia A Swan ◽  
Margaret Wells ◽  
...  
Keyword(s):  
Early Onset ◽  
Conditional Logistic Regression ◽  
Steering Committee ◽  
Post Traumatic Stress ◽  
Mild Tbi ◽  
Early Onset Dementia ◽  
Age Related ◽  
Severe Tbi ◽  
The Individual ◽  
The Impact

Abstract Evidence produced by studies using ICD-9 codes to identify dementia suggests that mild traumatic brain injury (mTBI) can accelerate age-related neurodegeneration and dementia risk. However, ICD-9 codes are unreliable in identifying early onset dementia (<65 years; EOD) in civilian (positive predictive value [PPV]=58%) and VA (PPV=28%). From 1,724 Veterans <65years of age with 2 or more dementia diagnoses based on ICD-9 codes recommended by VA Dementia Steering Committee, we validated dementia diagnoses in 153 randomly selected cases using medical chart abstractions and reviews by a neuropsychologist panel. We matched valid cases based on age, sex, race/ethnicity, year of entry to VA care, and branch of service to 2490 controls with no indicators of dementia or cognitive impairment. TBI severity was defined using multiple DoD and VA data sources. We also identified diagnoses for mental (e.g., depression, post-traumatic stress disorder, substance use disorders) and other medical conditions (e.g., stroke) associated with dementia. We used conditional logistic regression to examine the association of TBI severity with EOD controlling for comorbidity. After controlling for mental health and other comorbid conditions mild TBI (mTBI) was significantly associated with validated EOD [aOR( 95%CI): mTBI-4.5(2.4-8.9), moderate/severe TBI-21.3(8.4-54.3)]. Stroke, depression, PTSD, and headache were also associated with higher odds of EOD. These findings suggest that Veterans with mTBI are at risk for dementia, and clinicians should consider brief screening for cognitive dysfunction to ensure that they receive timely treatment to mitigate and address the impact of dementia on the individual, caregiver, family, and health care system

Broken Eagles: The Iron Age of Imperial Roman Warfare in Post-9/11 Film

2018 ◽  
pp. 243-258
Author(s):  
Alex McAuley
Keyword(s):  
Iron Age ◽  
Golden Age ◽  
Post Traumatic Stress ◽  
Roman Army ◽  
Post Traumatic ◽  
The Individual ◽  
The Cold War ◽  
The Impact ◽  
Imperial State ◽  
Fundamental Shift

In the second of three chapters that address Rome’s complicated legacy as an imperial state, McAuley contrasts the mid-twentieth century “golden old days” of ancient-world epics, which represented Roman soldiers as consummate professionals and warfare as neatly executed, with recent representations of the Roman army for post-9/11 audiences: a new “iron age” of betrayal, despair, and post-traumatic stress disorder. These films reflect a fundamental shift in the psychology of warfare and killing since Vietnam, which has created a vastly different and more ambiguous kind of conflict than the Cold-War binary of Spartacus (1960).McAuley examines the impact of this paradigm shift on contemporary depictions of the Roman army and its soldiers: first, by considering the “golden age” of Roman warfare in films from the 1950s and 1960s, in contrast with the dystopic view of Centurion(2010) and The Eagle (2011). He then traces the depiction of the individual Roman soldier in each era. Finally, he examines the broader contemporary context for post-9/11 depictions of antiquity: the growing body of films about the War on Terror, with which films like Centurion and The Eagle have far more in common than with their golden-age predecessors.

B-57 Post-traumatic Stress Disorder is a Stronger Predictor of Long-term Neurobehavioral Outcome than Traumatic Brain Injury Severity in U.S. Military Service Members

2019 ◽  
Vol 34 (6) ◽  
pp. 1003-1003
Author(s):  
R Lange ◽  
L French ◽  
S Lippa ◽  
J Bailie ◽  
T Brickell
Keyword(s):  
Military Service ◽  
Injury Severity ◽  
Strong Predictor ◽  
Post Traumatic Stress ◽  
Mild Tbi ◽  
Severe Tbi ◽  
Post Traumatic ◽  
Main Effects ◽  
Neurobehavioral Outcome

Abstract Objective The purpose of this study was to examine long-term neurobehavioral outcome in SMVs with versus without PTSD following TBI of all severities. Methods Participants were 536 SMVs recruited into three experimental groups (TBI, injured controls [IC], non-injured controls [NIC]). Participants completed the PTSD Checklist and the TBI-Quality of Life (TBI-QOL). Participants were divided into six subgroups based on the three experimental categories, two PTSD categories (i.e., present/absent), and two broad TBI severity categories (i.e., ‘unMTBI’ [includes uncomplicated mild TBI]; and ‘smcTBI’ [includes severe TBI, moderate TBI, and complicated mild TBI): (1) NIC/PTSD-Absent, (2) IC/PTSD-Absent, (3) unMTBI/PTSD-Absent, (4) unMTBI/PTSD-Present, (5) smcTBI/PTSD-Absent, and (6) smcTBI/PTSD-Present. Results There were significant main effects across the six groups for all TBI-QOL measures (p < .001). Select pairwise comparisons revealed significantly worse scores (p < .001) on all TBI-QOL measures in all PTSD-Present groups compared to the PTSD-Absent groups (i.e., Group 3v4 and 5v6; d = 0.90 to 2.11). In contrast, when controlling for PTSD, there were no significant differences between the TBI severity groups for all TBI-QOL measures (i.e., Group 3v5 and 4v6). In the TBI sample, a series of step-wise regression analyses revealed that PTSD, but not TBI severity, was consistently a strong predictor of all TBI-QOL scales (all p’s < .001), accounting for up to 64% of the variance. Conclusions These results provide support for the very strong influence of PTSD, but not TBI severity, on long-term neurobehavioral outcome following TBI. Concurrent PTSD and TBI of all severities should be considered a risk factor for poor long-term neurobehavioral outcome that requires ongoing monitoring.

scholarly journals Identity work of children with a parent with early-onset dementia in the Netherlands: Giving meaning through narrative construction

Dementia ◽  
2021 ◽  
pp. 147130122110334
Author(s):  
Silke Hoppe
Keyword(s):  
The Netherlands ◽  
Adult Children ◽  
Early Onset ◽  
Cultural Context ◽  
Late Onset ◽  
Making Meaning ◽  
Early Onset Dementia ◽  
The Impact ◽  
Depth Interviews ◽  
Late Onset Dementia

Background In the past years an increasing amount of research has been done on the experiences of adult children of a parent with early-onset dementia. However, little is still known about how the socio-cultural context influences the narratives of these children. Aim This study aimed to provide insights into the far-reaching consequences of parental early-onset dementia for adult children in the Netherlands. It illustrates how the experiences of these adult children are shaped by the context they live in. Method 16 in-depth interviews were conducted with adult children of a parent with early-onset dementia in the Netherlands. The interviews offered the children space to reflect on the impact the illness of their parent had on them and their lives. The data were analysed using thematic analysis. Findings This article illustrates that the comparative processes of relating to others' experiences help the children to reflect on the impact that their parent's illness has on their own lives, which in turn aids them in contextualising and making meaning out of their changing lives and relationships. This contextualization and recovery of meaning is shaped by three processes. The first concerns the ways these adult children draw comparisons between their own lives and experiences and those of their peers of the same age group. The second process entails comparative understandings of having a parent with early-onset dementia versus having a parent with late-onset dementia. The third process explores how having a parent with early-onset dementia compares to having a parent with other diseases. The processes of contextualisation which the adult children engage in are shaped by what the children perceive to be normal and thus also by their socio-cultural contexts. Conclusions This article reveals how meaning is created in a constant interplay between the primary experiences of having an ill parent and the socio-cultural context in which the experiences take place. It illustrates how this context provides for particular narratives, which in turn shape how the children are able to give meaning to their experiences.

The impact of criminal victimization

2012 ◽  
pp. 1984-1991
Author(s):  
Gillian C. Mezey ◽  
Ian Robbins
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Crime Victims ◽  
Economic Consequences ◽  
Voluntary Organizations ◽  
Post Traumatic Stress ◽  
Appropriate Treatment ◽  
The Individual ◽  
The Impact

The impact of crime on the individual victim is profound but is frequently underestimated by mental health professionals. Wide-ranging personal, social, and economic consequences could be prevented if a range of appropriate interventions were available. Most post traumatic stress treatment programmes in the United Kingdom have developed in response to specific disasters, which may not be relevant to or as effective with crime victims. In order to provide appropriate treatment to crime victims, mental health professionals need to recognize the importance of active interagency liaison with the police, the courts and with voluntary organizations such as victim support schemes. Crime victims tend to be relatively invisible and disempowered; they are less likely to be supported by active campaigning groups than survivors of major disasters and, because of associated feelings of shame and stigmatization, they may be reluctant to claim their entitlement to proper care and treatment. The fact that their plight is often used as a political football is likely to reinforce feelings of helplessness and insecurity. Given its prevalence, crime represents both an ordinary and an extraordinary event; it is likely to affect everyone at some point in their lives and the fact that most crime victims recover from the experience should not deprive those who need it, to proper care.

Application of survival analysis to the inception of dementia

1986 ◽  
Vol 16 (3) ◽  
pp. 583-593 ◽  
Author(s):  
Elizabeth Sturt
Keyword(s):  
Survival Analysis ◽  
Individual Differences ◽  
Statistical Methods ◽  
Early Onset ◽  
Age At Onset ◽  
Analytical Techniques ◽  
Early Onset Dementia ◽  
Degenerative Process ◽  
Age Related ◽  
The Difference

SynopsisThe age at onset of dementia of the Alzheimer, Pick or senile type in relatives of probands with early onset dementia was examined using survival analytical techniques applied to data collected by Sjögren et al. (1952). Female relatives were found to have a higher risk of dementia than males, and there was a deficit of affected brothers compared with fathers of probands. In these comparisons due allowance was made for age at the last observation of each relative. Relatives of probable and definite Pick probands had a higher risk than relatives of probable and definite Alzheimer probands, but the difference was not significant and dementia did not occur at an earlier age to the former group.For the relatives as a whole, and for subgroups of relatives, the risk of dementia increased with age, at least up to age 80. It is hypothesized that the pattern of the age-related hazard of dementia is due to the nature of the dementing process; that this slow degenerative process is widespread; and that individual differences in the rate of the process are under the influence of genes. The statistical methods are explained in detail as they have rarely been applied to dementia before, though Chase et al. (1983) have used life tables and survival analysis in testing genetic hypotheses, with an application to Alzheimer's disease.

scholarly journals Social effects on age-related and sex-specific immune cell profiles in a wild mammal

2019 ◽  
Author(s):  
Sil H. J. van Lieshout ◽  
Elisa Perez Badas ◽  
Michael W.T. Mason ◽  
Chris Newman ◽  
Christina D. Buesching ◽  
...  
Keyword(s):  
Immune Responses ◽  
Social Environment ◽  
Immune Cell ◽  
Meles Meles ◽  
Wild Mammal ◽  
Age Related ◽  
In The Wild ◽  
The Individual ◽  
The Impact ◽  
Age Related Changes

Evidence for age-related changes in innate and adaptive immune responses is increasing in wild populations. Such changes have been linked to fitness, and understanding the factors driving variation in immune responses is important for the evolution of immunity and senescence. Age-related changes in immune profiles may be due to sex-specific behaviour, physiology and responses to environmental conditions. Social conditions may also contribute to variation in immunological responses, for example, through transmission of pathogens and stress from resource and mate competition. Yet, the impact of the social environment on age-related changes in immune cell profile requires further investigation in the wild. Here, we tested the relationship between leukocyte cell composition (agranulocyte proportion, i.e. adaptive and innate immunity) and age, sex, and group size in a wild population of European badgers (Meles meles). We found that the proportion of agranulocytes decreased with age only in males living in small groups. In contrast, females in larger groups exhibited a greater age-related decline in the proportion of agranulocytes compared to females in smaller groups. Our results provide evidence for age-related changes in immune cell profiles in a wild mammal, which are influenced by both the sex of the individual and their social environment.

scholarly journals La resiliencia como estrategia de afrontamiento ante el estrés postraumático en combatientes

Enfoques ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 97
Author(s):  
Dayana Castillo ◽  
Paola Oyola ◽  
Carlos Enrique Garavito Ariza
Keyword(s):  
Coping Strategy ◽  
Traumatic Stress ◽  
Traumatic Event ◽  
Psychosocial Risk ◽  
Post Traumatic Stress ◽  
Factores De Riesgo ◽  
The Face ◽  
Post Traumatic ◽  
The Individual ◽  
The Impact

ResumenEl presente artículo presenta una aproximación teórica acerca de los factores de riesgo psicosocial asociados al trastorno de estrés postraumático en combatientes, como también el concepto de resiliencia como estrategia de afrontamiento ante los eventos de estrés postraumático en combatientes activos y las consecuencias en la aparición de depresión, ansiedad y síntomas asociados al estrés. Es así que se encuentra que el estrés desencadenado por un evento traumático se evidencia no solo en lo físico, sino también en lo emocional, afectando todos los contextos en los que se desarrolla el individuo. Para finalizar se presentan estrategias de desarrollo de resiliencia en población afectada por el conflicto armado. Las conclusiones del presente artículo dan cuenta del impacto del estrés postraumático en la población combatiente y la efectividad de la resiliencia como estrategia de afrontamiento. Resilience as a strategy for coping with post-traumatic stress in combatantsAbstractThis article presents a theoretical approach to the psychosocial risk factors associated with post-traumatic stress disorder in combatants, as well as the concept of resilience as a coping strategy in the face of post-traumatic stress events in active combatants and the consequences in the onset of depression, anxiety and symptoms associated with stress. Thus, it is found that the stress triggered by a traumatic event is evidenced not only in the physical, but also in the emotional, affecting all the contexts in which the individual develops. Finally, resilience development strategies are presented in the population affected by the armed conflict. The conclusions of this article show the impact of post-traumatic stress on the combatant population and the effectiveness of resilience as a coping strategy.  Resiliência como estratégia de enfrentamento do estresse póstraumático em combatentesResumoEste artigo apresenta uma abordagem teórica dos fatores de risco psicossocial associados ao transtorno de estresse pós-traumático em combatentes, bem como o conceito de resiliência como estratégia de enfrentamento frente a eventos de estresse pós-traumático em combatentes ativos e as conseqüências no início de depressão. , ansiedade e sintomas associados ao estresse. Assim, descobriu-se que o estresse desencadeado por um evento traumático é evidenciado não apenas no físico, mas também no emocional, afetando todos os contextos em que o indivíduo se desenvolve. Finalmente, as estratégias de desenvolvimento da resiliência são apresentadas na população afetada pelo conflito armado. As conclusões deste artigo mostram o impacto do estresse pós-traumático na população combatente e a eficácia da resiliência como estratégia de enfrentamento.

scholarly journals Early-Onset Dementia in War Veterans: Brain Polypathology and Clinicopathologic Complexity

2019 ◽  
Vol 79 (2) ◽  
pp. 144-162 ◽  
Author(s):  
Diego Iacono ◽  
Patricia Lee ◽  
Brian L Edlow ◽  
Nichelle Gray ◽  
Bruce Fischl ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Early Onset ◽  
Ex Vivo ◽  
Chronic Traumatic Encephalopathy ◽  
Post Traumatic Stress ◽  
Early Onset Dementia ◽  
Behavioral Abnormalities ◽  
Before And After ◽  
Clinicopathologic Findings ◽  
Pathologic Lesions

Abstract The neuropathology associated with cognitive decline in military personnel exposed to traumatic brain injury (TBI) and chronic stress is incompletely understood. Few studies have examined clinicopathologic correlations between phosphorylated-tau neurofibrillary tangles, β-amyloid neuritic plaques, neuroinflammation, or white matter (WM) lesions, and neuropsychiatric disorders in veterans. We describe clinicopathologic findings in 4 military veterans with early-onset dementia (EOD) who had varying histories of blunt- and blast-TBI, cognitive decline, behavioral abnormalities, post-traumatic stress disorder, suicidal ideation, and suicide. We found that pathologic lesions in these military-EOD cases could not be categorized as classic Alzheimer’s disease (AD), chronic traumatic encephalopathy, traumatic axonal injury, or other well-characterized clinicopathologic entities. Rather, we observed a mixture of polypathology with unusual patterns compared with pathologies found in AD or other dementias. Also, ultrahigh resolution ex vivo MRI in 2 of these 4 brains revealed unusual patterns of periventricular WM injury. These findings suggest that military-EOD cases are associated with atypical combinations of brain lesions and distribution rarely seen in nonmilitary populations. Future prospective studies that acquire neuropsychiatric data before and after deployments, as well as genetic and environmental exposure data, are needed to further elucidate clinicopathologic correlations in military-EOD.

scholarly journals Psychosocial impact of early onset dementia among caregivers

2015 ◽  
Vol 37 (4) ◽  
pp. 213-219 ◽  
Author(s):  
Nathália R. S. Kimura ◽  
Virgínia L. R. Maffioletti ◽  
Raquel L. Santos ◽  
Maria Alice Tourinho Baptista ◽  
Marcia C. N. Dourado
Keyword(s):  
Mental Health ◽  
Early Onset ◽  
Social Impact ◽  
Mental Health Problems ◽  
Psychosocial Impact ◽  
Emotional Impact ◽  
Physical And Mental Health ◽  
Early Onset Dementia ◽  
People With Dementia ◽  
The Impact

Introduction: There is growing recognition of early onset dementia (EOD) as a significant clinical and social problem because of its effects on physical and mental health of people with dementia (PWD) and their caregivers. Objective: To analyze the psychosocial impact of EOD in family caregivers. Methods: The study design was qualitative. Nine EOD caregivers (7 women) were recruited at a service for Alzheimer's disease and assessed using semi-structured interviews. Interpretative phenomenological analysis was used to analyze caregivers' reports. Results: Five themes emerged from the narratives: psychological and emotional impact; physical impact; financial and professional impact; social impact and need for support services. The majority of the caregivers of people with EOD perceived their emotional wellbeing as poor or extremely poor. Carers reported poor physical health, which tends to be longer-lasting than mental health problems. Two caregivers had to retire after the disclosure of the dementia diagnosis, and seven reduced their work loads because they had to look after PWD. Preserving the abilities of PWD is essential to maintain their self-esteem, dignity and sense of utility. For the caregivers, interventions and stimulating activities make PWD feel worthwhile and contribute to improving life. Conclusion: The caregivers of people with EOD assume the role of caregiver prematurely and need to balance this activity with other responsibilities. There is a need for more studies of EOD in order to improve understanding of the impact of this disease and to enable development of adequate services for PWD and their caregivers.

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