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Examining the Connections Between Alzheimer’s and Military Veterans

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Alzheimer’s disease and dementia research can grow only within their available funding. That’s one reason why research into connections between the diseases and military veterans is still in the preliminary stages.

But the need for that research has lately grown acute. With more and more soldiers being injured by improvised explosive devices (IEDs), traumatic brain injury (TBI)—and its attending dementia—has been on the rise.

According to the Department of Defense’s Defense and Veterans Brain Injury Center, there have been 220,430 cases of TBI among service members since 2000, when the Pentagon began keeping records. In 2010 alone there were 31,353 cases; as of the second quarter of 2011, the number is 17,439.

Dr. Heather Snyder, senior associate director of Medical & Scientific Relations for the Alzheimer’s Association, points out that not everyone who has had a TBI goes on to have dementia. Nor is everyone with dementia the victim of a TBI. When it comes to head injuries, Snyder notes, many different factors come into play.

Nonetheless, the preliminary tallies strongly indicate at least some cause for concern.

Some of these concerns arose at the recent Alzheimer’s Association International Conference 2011 in Paris. One of the speakers was Dr. Kristine Yaffe, a professor of psychiatry, neurology and epidemiology at the University of California, San Francisco. She stressed the importance of clarifying the link between TBI and dementia with the surge in soldiers experiencing a TBI in combat.

Yaffe, who is also the director of the Memory Disorders Program at the San Francisco VA Medical Center, and her team reviewed medical records for 281,540 U.S. veterans 55 years or older who had received care through the Veterans Health Administration. The subjects, who did not have dementia diagnoses at the start of the study, had had at least one in-patient or out-patient visit between 1997 and 2000 and a follow-up from 2001 to 2007. The team searched the database to see if a connection between TBI of any type was associated with a greater risk of dementia. At the same time, they noted demographics and other medical conditions including psychiatric disorders.

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The results showed that the risk of dementia was 15.3 percent in those with a TBI diagnosis, compared with 6.8 percent in those without. This was a more than two-fold increase in the risk of developing dementia over seven years—and was significant for all TBI types.

“This issue is important because TBI is very common,” said Yaffe in a July 18 Alzheimer’s Association release. “About 1.7 million people experience a TBI each year in the United States, primarily due to falls and car crashes. TBI is also referred to as the ‘signature wound’ of the conflicts in Iraq and Afghanistan, where TBI accounts for 22 percent of casualties overall and 59 percent of blast-related injuries.”

Those injuries are most likely connected with IEDs. Basically improvised booby traps, often homemade and containing shrapnel or a combination of chemicals, IEDs are tough to defeat because they are hard to detect.

But in September, wrote that top military officials, including Chairman of the Joint Chiefs of Staff Adm. Mike Mullen, now see the scope of the problem and are taking action.

As stated earlier, one of the biggest issues hampering the research into connections between dementia and veterans is a lack of funding. When compared with funding for, say, cancer research, allotments for Alzheimer’s are a very small part of the national health-care budget. However, in the last Department of Defense budget, $15 million was set aside for Alz­heimer’s research.

The funding was largely the work of Democratic representatives Jim Moran from Virginia, Steve Israel from New York and Norm Dicks from Washington state. The money will be used to study if veterans are more susceptible to Alzheimer’s than non-veterans, and look into certain risk factors of dementia including genes, TBI and post-traumatic stress disorder.

“The flexible research program being run through the Department of Defense will allow our military to take advantage of the latest Alzheimer’s research breakthroughs, producing savings many, many times greater than the investment,” said Moran. And Snyder put the matter baldly: “It’s time as a society to make a commitment to Alz­heimer’s research.”