The Role of Mental Health Conditions in Early Detection and Treatment of Veterans With Alzheimer’s Dementia

Author:

O’Connor Maureen K12,Aguilar Byron J1,Nguyen Andrew1ORCID,Berlowitz Dan3,Zhang Raymond4,Tahami Monfared Amir Abbas45,Zhang Quanwu4,Xia Weiming167ORCID

Affiliation:

1. Geriatric Research Education and Clinical Center, VA Bedford Healthcare System , Bedford, MA 01730, USA

2. Department of Neurology, Boston University School of Medicine , Boston, MA 02118, USA

3. Zuckerberg College of Health Sciences, University of Massachusetts Lowell , Lowell, MA 01854, USA

4. Alzheimer’s Disease and Brain Health, Eisai Inc. , Nutley, NJ 07110, USA

5. Department of Epidemiology, Biostatistics and Occupational Health, McGill University , Montreal, QC H3A 0G4, Canada

6. Department of Pharmacology, Physiology and Biophysics, Boston University Chobanian & Avedisian School of Medicine , Boston, MA 02118, USA

7. Department of Biological Sciences, Kennedy College of Sciences, University of Massachusetts Lowell , 198 Riverside Street, Lowell, MA 01854, USA

Abstract

ABSTRACT Introduction The benefits of early detection of Alzheimer’s disease (AD) have become increasingly recognized. Veterans with mental health conditions (MHCs) may be less likely to receive a specific AD diagnosis compared to veterans without MHCs. We investigated whether rates of MHCs differed between veterans diagnosed with unspecified dementia (UD) vs. AD to better understand the role MHCs might play in establishing a diagnosis of AD. Materials and Methods This retrospective analysis (2015-2022) identified UD and AD with diagnostic code–based criteria. We determined the proportion of veterans with MHCs in UD vs. AD cohorts. Secondarily, we assessed the distribution of UD/AD diagnoses in veterans with and without MHCs. Results We identified 145,309 veterans with UD and 33,996 with AD. The proportion of each MHC was consistently higher in UD vs. AD cohorts: 41.4% vs. 33.2% (depression), 26.9% vs. 20.3% (post-traumatic stress disorder), 23.4% vs. 18.2% (anxiety), 4.3% vs. 2.1% (bipolar disorder), and 3.9% vs. 1.5% (schizophrenia). The UD diagnostic code was used in 84% of veterans with MHCs vs. 78% without MHCs (P < .001). Conclusions Mental health conditions were more likely in veterans with UD vs. AD diagnoses; comorbid MHC may contribute to delayed AD diagnosis.

Funder

Eisai Incorporated

Nih

Publisher

Oxford University Press (OUP)

Reference12 articles.

1. How the VA plans to keep up with an aging veteran population;Campos,2022

2. Fiscal Years 2022-28 Strategic Plan 16;Department of Veterans Affairs,2022

3. Health, and exposure risks associated with cognitive loss, Alzheimer’s disease and other dementias in US military veterans;Zhu;Front Psychiatry,2021

4. Veterans;Statistical Projections of all Types of Dementia for VA Patients, VA Enrollees, and U.S,2021

5. Clinical staging of Alzheimer’s disease: concordance of subjective and objective assessments in the veteran’s affairs healthcare system;Morin;Neurol Ther,2022

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