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Subjective cognitive decline and comorbid chronic conditions among United States veterans, 2015‐2018
Author(s) -
Gupta Sangeeta
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.036351
Subject(s) - medicine , comorbidity , diabetes mellitus , dementia , stroke (engine) , behavioral risk factor surveillance system , kidney disease , obesity , veterans affairs , blood pressure , physical therapy , risk factor , disease , public health , pathology , mechanical engineering , engineering , endocrinology
Background Subjective Cognitive Decline (SCD) is the self‐reported persistent decline in cognitive performance not detected objectively by neuropsychological tests (1). Epidemiological data have shown that individuals with SCD are at increased risk of progression to Alzheimer’s disease (AD) and related dementia (1). Veterans are at higher risk for Alzheimer’s as a consequence of traumatic brain injury, post‐traumatic stress disorder, and/or service‐related injuries (2). Co‐morbid chronic conditions create additional issues related to cost, medical care, and care giving. Some chronic conditions (diabetes, obesity, myocardial infarction, stroke, high cholesterol and high blood pressure) may further increase the risk for developing AD (1‐3). The objective of this study was to use data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine the prevalence of SCD; functional limitations and comorbidity with chronic conditions in US veterans. Method Combined BRFSS data for 2015 through 2018 (n= 1815211) were analyzed. 10.6% self‐identified as veterans (n=235683). Multiple chronic conditions (MCC) were defined as 2 or more chronic conditions that affect a person at the same time (4). 12 chronic conditions: angina, arthritis, asthma, cancer, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, high blood pressure, high cholesterol, heart attack, obesity, and stroke were used in the analyses. Result Among veterans, 12.9 % reported SCD. Of the veterans reporting SCD: 93.3% were males; 79.4% White Non‐Hispanics and 52.4% reported functional difficulties. SCD prevalence increased with age, from 17.6% among veterans aged 45–54 years to 60.2% among those aged ≥65 years and was lower among college graduates (19.5%) compared to those with less than college education (80.5%). More than fifty percent veterans (51.8%) reporting SCD had not talked to a health care professional. Burden of co‐morbid diabetes, smoking, obesity, myocardial infarction, stroke, high cholesterol and high blood pressure had a significant association with SCD. 77.5% of veterans reporting SCD had MCC. Conclusion As a precursor to dementia, including Alzheimer’s, early assessment of cognitive issues in veterans is critical. Significant association of chronic conditions with SCD is disturbing. Identifying the burden of associated chronic conditions can further support veteran health providers in ensuring appropriate and timely case management.