Post‐traumatic stress disorder and dementia in veterans: A scoping literature review

Abstract

Emerging research has found an association between post‐traumatic stress disorder (PTSD) and dementia in veterans, yet little is known about the nature of this association and how it is conceptualized in the literature. The purpose of this scoping review is to understand how the relationship between PTSD and dementia in veterans is recognized and described in the peer‐reviewed literature. A scoping review was conducted using Arksey and O'Malley's (International Journal of Social Research Methodology, 8, 19, 2005) framework. Articles are included if participants were veterans with a focus on PTSD and dementia. A total of six databases (CINAHL, MEDLINE, EMBASE, PsycINFO, HealthSTAR, and PubMed) were searched along with the reference lists of eligible sources in September 2018. Thematic analysis was used to summarize the data. Thirty‐six studies were included in this review. Three main themes emerged from the literature: (i) symptomatic expression of PTSD and dementia; (ii) aetiology underlying the relationship between PTSD and dementia; and (iii) implications of PTSD and dementia on healthcare providers, treatment, and resources. This study highlights the ongoing need to understand mechanisms underlying the association between PTSD and dementia, the need for definition of PTSD symptoms, and to sensitize healthcare providers to the presence of PTSD when caring for veterans with dementia.

Estrogenic Plants: to Prevent Neurodegeneration and Memory Loss and Other Symptoms in Women After Menopause

“…AD is a neurodegenerative disease characterized by cholinergic deficits, neuronal loss, glial dysfunction ( Echeverria et al, 2009 ), intracellular and extracellular accumulation of aggregated forms of Aβ, and the appearance of intraneuronal neurofibrillary tangles of hyperphosphorylated Tau in the brain ( McGeer, 1986 ; Mann, 1989 ; Masdeu et al, 2005 ). The main risk factors involve traumatic brain injury ( Gardner and Yaffe, 2015 ; Daulatzai, 2017 ), posttraumatic stress disorder (PTSD) ( Tsolaki et al, 2009 ; Meziab et al, 2014 ; Ritchie et al, 2019 ), diabetes ( Chen and Zhong, 2013 ; Boccardi et al, 2019 ; Jash et al, 2020 ), and age ( Simpson et al, 2010 ; Bartzokis, 2011 ; Bove et al, 2014 ). These abnormalities occur with neuroinflammation and oxidative stress that orchestrate a cascade of events leading to cognitive decline, gliosis, and synaptic loss.…”

PTSD Symptoms and Dementia in Older Veterans Who are Living in Long-Term Care

“…Three interview guides were developed to explore the experience of co-occurring PTSD symptoms and dementia from each of the participants’ perspectives. The interview questions were informed from previous research by the authors (Ritchie et al, 2019) and were designed to elicit behaviors, opinions/values, feelings, and knowledge about co-occurring PTSD symptoms and dementia from each of the participants (Veterans, caregivers, and healthcare providers) (Britten, 1995; Patton, 1987). Multiple rounds of consultation with stakeholders at each facility and within the thesis committee served to refine the interview questions.…”

Understanding how Canadian healthcare providers have learned to identify co‐occurring PTSD symptoms and dementia in Veterans

“…The PI conducted semi-structured interviews lasting 35 to 75 minutes with all participants between January and August 2019. A semistructured interview guide was developed based on findings from a prior scoping review by the authors (Ritchie et al, 2019) and informed by the principles of CIT (Kemppainen, 2000). Interview questions were designed to elicit reflection and a specific description of a critical incident involving the healthcare providers experience in caring for a Veteran with co-occurring PTSD and dementia living in long-term care.…”

“…Currently, there are no training materials or clinical guidelines available for identifying co‐occurring dementia and PTSD in Veterans in long‐term care (LTC) (Bruneau et al, 2020; Jacobs & Dinoff, 2012; Martinez‐Clavera et al, 2017). Instead, most of the literature consists of case studies describing individual accounts of PTSD symptoms and dementia in older Veterans (Dallam et al, 2011; Ritchie et al, 2019). There is a need for research to improve the identification of PTSD symptoms and dementia in Veterans to inform more effective care strategies (Bruneau et al, 2020).…”