Affiliation:
1. Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx New York USA
2. The Saul R Korey Department of Neurology Albert Einstein College of Medicine Bronx New York USA
3. Department of Family, Population and Preventive Medicine Renaissance School of Medicine at Stony Brook University Stony Brook New York USA
4. Montefiore Medical Center Albert Einstein College of Medicine Bronx New York USA
5. World Trade Center Program Clinical Center of Excellence Renaissance School of Medicine at Stony Brook University Stony Brook New York USA
6. Department of Medicine Renaissance School of Medicine at Stony Brook University Stony Brook New York USA
7. Rush Alzheimer's Disease Center Rush University Medical Center Chicago Illinois USA
8. Department of Psychiatry and Behavioral Sciences Rush University Medical Center Chicago Illinois USA
Abstract
AbstractBackgroundPosttraumatic stress disorder (PTSD) symptomatology and poorer pulmonary function are highly prevalent psychiatric and medical conditions. In the present study, we tested for the individual, additive, and modifying associations of PTSD symptomatology and pulmonary function with cognitive performance.MethodsIn this cross‐sectional study, a total of 1,401 World Trade Center (WTC) responders (mean age = 53, SD = 8 years, 92% males) participated in the study. Cogstate assessment measured cognitive performance. PTSD symptomatology was measured using the trauma‐specific version of the posttraumatic stress disorder checklist (PCL‐17) adapted for the WTC attacks. The 1‐second forced expiratory volume and forced vital capacity (FEV1/FVC) ratio was used to measure pulmonary function. Linear regressions with cognitive performance as the outcome were conducted to assess individual, additive, and moderating associations of PTSD symptomatology and pulmonary function.ResultsHigher PTSD symptomatology and poorer pulmonary function were negatively associated with cognitive performance. A 10% increase on the FEV1/FVC ratio moderated the association between PTSD symptomatology and cognition, whereby its association with cognition was stronger when PTSD symptomatology was higher (est. = 0.01, 95%CI = 0.004, 0.01, p < 0.001). When stratified by responder type, these associations persisted in trained (est. = 0.01, 95%CI = 0.01, 0.02, p < 0.001), but not in non‐trained (est. = 0.004, 95% C.I. = −0.01, 0.02, p = 0.39) responders.ConclusionsIn the presence of higher PTSD, better pulmonary functioning is associated with better cognitive performance. Early intervention efforts to mitigate preventable cognitive decline in high‐risk populations should be studied, especially since intervention in one modality may have an impact on others.