Middle-aged women with PTSD experience accelerated cognitive decline
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In middle-aged women, PTSD was associated with a quicker decline in cognitive function, according to a prospective analysis of the Nurses’ Health Study II, a longitudinal study involving middle-aged female nurses.
“Our findings suggest that earlier cognitive screening may be recommended for women who ever experienced severe PTSD symptoms, as they may encounter a faster cognitive decline during aging and are predisposed to a higher risk of dementia,” Jiaxuan (Jessie) Liu, MPH, a PhD candidate in epidemiology at the Harvard T.H. Chan School of Public Health in Boston, told Healio. “Our findings also highlight the importance of PTSD prevention and treatment across the lifespan.”
Liu and colleagues assessed 12,270 women (mean age, 61.1 years; 95.9% non-Hispanic white) who had experienced trauma and were enrolled in a sub-study of the Nurses’ Health Study II focused on PTSD and had completed between one and five cognitive assessments from March 1, 2008, to July 30, 2019.
For the present study, which was published in JAMA Network Open, women self-administered the Cogstate Brief Battery every 6 or 12 months for up to 24 months between Oct. 3, 2014, and July 30, 2019. The researchers evaluated changes in cognitive function using the composite score for psychomotor speed and attention and the composite score for learning and working memory.
PTSD symptoms were divided into four levels of increasing severity, with the first level defined as zero symptoms and the last defined as six or seven symptoms.
Overall, having more PTSD symptoms was associated with worse cognitive trajectories. For instance, women with six or seven symptoms had significantly worse change in mean composite scores for psychomotor speed and attention (B = –0.05 standard deviation per year [SD/y]; 95% CI, –0.09 SD/y to –0.01 SD/y) and for learning and working memory (B = –0.08 SD/y; 95% CI, –0.11 SD/y to –0.04 SD/y) compared with women who had no symptoms. Women with four or five symptoms also had worse decline in learning and working memory (B = –0.03 SD/y; 95% CI, –0.06 SD/y to –0.003 SD/y) compared with those who had no symptoms, but not for psychomotor speed and attention.
Both composite scores were similar between women who experienced one to three PTSD symptoms and those who had no PTSD symptoms.
“We found that the association between PTSD and cognitive decline was not explained by lifestyle factors and health conditions known to predict cognition, such as alcohol consumption, physical activity, diabetes and stroke, although depression co-occurring with PTSD accounted for part of the association,” Liu said.
Moving forward, Liu suggested researchers examine the mechanisms underlying the association between active PTSD and cognitive decline, as well as “the cognitive trajectory among individuals whose PTSD symptoms remitted.”