Changes in Health Status in the Ft. Devens Gulf War Veterans Cohort: 1997-2017

Gulf War veterans (GWVs) were exposed to numerous neurotoxicants during deployment. Upon returning home, many reported a multitude of symptoms including fatigue, pain, gastrointestinal and respiratory issues, and neurological, cognitive, and mood complaints, collectively termed “Gulf War Illness (GWI).” Now, nearly 30 years post-war, many GWVs continue to suffer from these symptoms, in addition to health concerns associated with normal aging. While most research on GWVs has been cross-sectional, it is important to evaluate the progression and onset of new GWI symptoms longitudinally. The current study investigated the health of GWVs 25+ years after the war by resurveying the Ft. Devens Cohort and comparing their current health to their health reported 15 to 20 years earlier. The sample consists of 317 GWVs (~54 years old at the latest survey, 38 women) who responded to both surveys (1997-1998 and 2013-2017). Multivariable regression analyses were used to assess changes in GWI symptomatology and prevalence of medical conditions. The rates of 12 of 25 health symptoms increased significantly from the prior 1997-1998 survey. Anxiety, numbness in extremities, depressed mood, and joint pain had the greatest increase in endorsement. The rates of 7 of 16 medical conditions increased significantly from the prior 1997-1998 survey. High blood pressure, diabetes, and cancer had the greatest increase in prevalence. In summary, this study demonstrates that both symptoms and physician-diagnosed medical conditions associated with GW deployment/exposure increased in prevalence. For GWVs, focus by providers on the treatment of cognitive and mental health issues as well as cardiovascular and cerebrovascular risk factors is warranted. Targeting symptom alleviation would help improve the quality of life in these veterans until treatments addressing the entire illness become available.

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PMH54: MENTAL HEALTH COMORBIDITY PREVALENCE, PATTERNS, AND IMPACT ON QUALITY OF LIFE AMONG GULF WAR VETERANS

Value in Health ◽

10.1016/s1098-3015(10)64256-8 ◽

2003 ◽

Vol 6 (3) ◽

pp. 362-363

Author(s):

VL Forman ◽

CP Carney ◽

P Peloso ◽

RF Woolson ◽

DW Black ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Gulf War ◽

War Veterans ◽

Gulf War Veterans

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Quality of Life in Gulf War Veterans: the Influence of Recency and Persistence of Psychiatric Morbidity

Applied Research in Quality of Life ◽

10.1007/s11482-017-9579-7 ◽

2018 ◽

Vol 14 (1) ◽

pp. 23-38 ◽

Cited By ~ 1

Author(s):

Breanna K. Wright ◽

Helen L. Kelsall ◽

Malcolm R. Sim ◽

David M. Clarke

Keyword(s):

Quality Of Life ◽

Psychiatric Morbidity ◽

Gulf War ◽

War Veterans ◽

Gulf War Veterans

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Mental health of US Gulf War veterans 10 years after the war

The British Journal of Psychiatry ◽

10.1192/bjp.bp.105.019539 ◽

2007 ◽

Vol 190 (5) ◽

pp. 385-393 ◽

Cited By ~ 51

Author(s):

Rosemary Toomey ◽

Han K. Kang ◽

Joel Karlinsky ◽

Dewleen G. Baker ◽

Jennifer J. Vasterling ◽

...

Keyword(s):

Quality Of Life ◽

Mental Disorders ◽

Psychological Symptoms ◽

Gulf War ◽

War Veterans ◽

Clinical Interviews ◽

Gulf War Veterans ◽

Temporal Course ◽

Prevalence Of Depression

BackgroundGulf War veterans reported multiple psychological symptoms immediately after the war; the temporal course of these symptoms remains unclear.AimsTo assess the prevalence of war-era onset mental disorders in US veterans deployed to the Gulf War and in non-deployed veterans 10 years after the war.MethodMental disorders were diagnosed using structured clinical interviews. Standard questionnaires assessed symptoms and quality of life.ResultsGulf War-era onset mental disorders were more prevalent in deployed veterans (18.1%, n=1061) compared with non-deployed veterans (8.9%, n=1128). The prevalence of depression and anxiety declined 10 years later in both groups, but remained higher in the deployed group, who also reported more symptoms and a lower quality of life than the non-deployed group. Remission of depression may be related to the presence of comorbid psychiatric disorders and level of education. Remission of anxiety was related to treatment with medication.ConclusionsGulf War deployment was associated with an increased prevalence of mental disorders, psychological symptoms and a lower quality of life beginning during the war and persisting at a lower rate 10 years later.

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Healthcare utilization and mortality among veterans of the Gulf War

Philosophical Transactions of the Royal Society B Biological Sciences ◽

10.1098/rstb.2006.1816 ◽

2006 ◽

Vol 361 (1468) ◽

pp. 553-569 ◽

Cited By ~ 16

Author(s):

Gregory C Gray ◽

Han K Kang

Keyword(s):

Healthcare Utilization ◽

Gulf War ◽

Future Research ◽

War Veterans ◽

Vast Number ◽

Gulf War Veterans ◽

Increased Risk ◽

Utilization Data ◽

Post War ◽

Health Registry

The authors conducted an extensive search for published works concerning healthcare utilization and mortality among Gulf War veterans of the Coalition forces who served during the1990–1991 Gulf War. Reports concerning the health experience of US, UK, Canadian, Saudi and Australian veterans were reviewed. This report summarizes 15 years of observations and research in four categories: Gulf War veteran healthcare registry studies, hospitalization studies, outpatient studies and mortality studies. A total of 149 728 (19.8%) of 756 373 US, UK, Canadian and Australian Gulf War veterans received health registry evaluations revealing a vast number of symptoms and clinical conditions but no suggestion that a new unique illness was associated with service during the Gulf War. Additionally, no Gulf War exposure was uniquely implicated as a cause for post-war morbidity. Numerous large, controlled studies of US Gulf War veterans' hospitalizations, often involving more than a million veterans, have been conducted. They revealed an increased post-war risk for mental health diagnoses, multi-symptom conditions and musculoskeletal disorders. Again, these data failed to demonstrate that Gulf War veterans suffered from a unique Gulf War-related illness. The sparsely available ambulatory care reports documented that respiratory and gastrointestinal complaints were quite common during deployment. Using perhaps the most reliable data, controlled mortality studies have revealed that Gulf War veterans were at increased risk of injuries, especially those due to vehicular accidents. In general, healthcare utilization data are now exhausted. These findings have now been incorporated into preventive measures in support of current military forces. With a few diagnostic exceptions such as amyotrophic lateral sclerosis, mental disorders and cancer, it now seems time to cease examining Gulf War veteran morbidity and to direct future research efforts to preventing illness among current and future military personnel.

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