Military Risk Factors and Dementia in Veterans: The Impact of Race and Social Determinants of Health

Abstract

Alzheimer’s disease and related dementias (ADRD) are among the most common and debilitating disorders that occur in older adults. With many more Veterans surviving into old age, coupled with the military’s increasing diversity, understanding Veterans’ risk of ADRD and differences by race/ethnicity and by United States (U.S.) region is critically important for Veterans’ and all Americans’ health. Veterans are exposed to military-related risk factors such as traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), and cardiovascular risk factor (CVRFs), which may impact their risk of dementia and also play a role in racial disparities. Social determinants of health, including income, education, and neighborhood disadvantage, may also impact dementia risk, but are less studied among Veterans. Investigating both military-related risk factors and social determinants of health may offer important pathways to reduce health disparities for ADRD among Veterans. Critically, information we gather will be important for trying to prevent or reduce the risk of ADRD and offer new avenues for treatment. This project aims to investigate the effects of military risk factors, social determinants of health, and how they interact with race/ethnicity on the risk of dementia. We plan to leverage the strength of a large and diverse electronic-medical record database of older Veterans across the entire U.S., as well as an incredibly experienced research team, to conduct our proposed science. We will disentangle the complex relationship between military risk factors, social determinants of health, race, and risk of dementia and determine how military risk factors and social determinants of health may underlie health disparities of ADRD. We will also determine how these factors may influence regional differences in dementia incidence. We hypothesize that Black and Hispanic older Veterans will have greater military risk factors compared to White Veterans and that less advantageous social determinants of health are associated with greater military risk factors and increased risk of developing dementia. We hypothesize that these differences in military-related risk factors and social determinants of health will partially explain racial disparities in dementia risk and regional differences in dementia incidence. Understanding the complex relationships between military-related risk factors, race/ethnicity, and social determinants of health is vital for plans to address individual, VA, and U.S. public health burden as well as to inform VA and other healthcare systems about how best to allocate resources and reduce disparities. Findings from the proposed study may identify populations and geographical regions that could benefit from early intervention to reduce future dementia, and will inform methods for intervening, preventing, and reducing risk of dementia as well as improving quality of life in all Veterans.

Document Details

Document Type
DoD Grant Award
Publication Date
Dec 28, 2022
Source ID
W81XWH2210961

Entities

People

  • Kristine Yaffe

Organizations

  • Northern California Institute for Research and Education
  • United States Army

Tags

Fields of Study

  • Medicine
  • Psychology

Readers

  • Mental Health of Military Veterans with Posttraumatic Stress Disorder (PTSD): Risk Factors, Prevalence, Symptoms, and Treatment.
  • Systems Analysis and Design
  • Traumatic Brain Injury (TBI) and Cognitive Aging in the Guam and Border Populations Affected by Alzheimer's Disease and Tau-Associated Dementias.

Technology Areas

  • Microelectronics