The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up study
IntroductionGulf War Illness (GWI), also called Chronic Multisymptom Illness (CMI), is a multi-faceted condition that plagues an estimated 250,000 Gulf War (GW) veterans. Symptoms of GWI/CMI include fatigue, pain, and cognitive dysfunction. We previously reported that 12% of a convenience sample of...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-01-01
|
| Series: | Frontiers in Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1301066/full |
| _version_ | 1797349435585331200 |
|---|---|
| author | Linda L. Chao Linda L. Chao Linda L. Chao Kimberly Sullivan Maxine H. Krengel Ronald J. Killiany Lea Steele Nancy G. Klimas Nancy G. Klimas Bang-Bong Koo |
| author_facet | Linda L. Chao Linda L. Chao Linda L. Chao Kimberly Sullivan Maxine H. Krengel Ronald J. Killiany Lea Steele Nancy G. Klimas Nancy G. Klimas Bang-Bong Koo |
| author_sort | Linda L. Chao |
| collection | DOAJ |
| description | IntroductionGulf War Illness (GWI), also called Chronic Multisymptom Illness (CMI), is a multi-faceted condition that plagues an estimated 250,000 Gulf War (GW) veterans. Symptoms of GWI/CMI include fatigue, pain, and cognitive dysfunction. We previously reported that 12% of a convenience sample of middle aged (median age 52 years) GW veterans met criteria for mild cognitive impairment (MCI), a clinical syndrome most prevalent in older adults (e.g., ≥70 years). The current study sought to replicate and extend this finding.MethodsWe used the actuarial neuropsychological criteria and the Montreal Cognitive Assessment (MoCA) to assess the cognitive status of 952 GW veterans. We also examined regional brain volumes in a subset of GW veterans (n = 368) who had three Tesla magnetic resonance images (MRIs).ResultsWe replicated our previous finding of a greater than 10% rate of MCI in four additional cohorts of GW veterans. In the combined sample of 952 GW veterans (median age 51 years at time of cognitive testing), 17% met criteria for MCI. Veterans classified as MCI were more likely to have CMI, history of depression, and prolonged (≥31 days) deployment-related exposures to smoke from oil well fires and chemical nerve agents compared to veterans with unimpaired and intermediate cognitive status. We also replicated our previous finding of hippocampal atrophy in veterans with MCI, and found significant group differences in lateral ventricle volumes.DiscussionBecause MCI increases the risk for late-life dementia and impacts quality of life, it may be prudent to counsel GW veterans with cognitive dysfunction, CMI, history of depression, and high levels of exposures to deployment-related toxicants to adopt lifestyle habits that have been associated with lowering dementia risk. With the Food and Drug Administration’s recent approval of and the VA’s decision to cover the cost for anti-amyloid β (Aβ) therapies, a logical next step for this research is to determine if GW veterans with MCI have elevated Aβ in their brains. |
| first_indexed | 2024-03-08T12:30:12Z |
| format | Article |
| id | doaj.art-6970eb828d10432bbb276f17ac75f0c6 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-08T12:30:12Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-6970eb828d10432bbb276f17ac75f0c62024-01-22T04:23:52ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2024-01-011710.3389/fnins.2023.13010661301066The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up studyLinda L. Chao0Linda L. Chao1Linda L. Chao2Kimberly Sullivan3Maxine H. Krengel4Ronald J. Killiany5Lea Steele6Nancy G. Klimas7Nancy G. Klimas8Bang-Bong Koo9Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United StatesDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United StatesSan Francisco Veterans Affairs Health Care System, San Francisco, CA, United StatesDepartment of Environmental Health, Boston University School of Public Health, Boston, MA, United StatesDepartment of Neurology, Boston University School of Medicine, Boston, MA, United StatesDepartment of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United StatesDepartment of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United StatesDr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, United StatesGeriatric Research Education and Clinical Center (GRECC), Miami VA Medical Center, Miami, FL, United StatesDepartment of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United StatesIntroductionGulf War Illness (GWI), also called Chronic Multisymptom Illness (CMI), is a multi-faceted condition that plagues an estimated 250,000 Gulf War (GW) veterans. Symptoms of GWI/CMI include fatigue, pain, and cognitive dysfunction. We previously reported that 12% of a convenience sample of middle aged (median age 52 years) GW veterans met criteria for mild cognitive impairment (MCI), a clinical syndrome most prevalent in older adults (e.g., ≥70 years). The current study sought to replicate and extend this finding.MethodsWe used the actuarial neuropsychological criteria and the Montreal Cognitive Assessment (MoCA) to assess the cognitive status of 952 GW veterans. We also examined regional brain volumes in a subset of GW veterans (n = 368) who had three Tesla magnetic resonance images (MRIs).ResultsWe replicated our previous finding of a greater than 10% rate of MCI in four additional cohorts of GW veterans. In the combined sample of 952 GW veterans (median age 51 years at time of cognitive testing), 17% met criteria for MCI. Veterans classified as MCI were more likely to have CMI, history of depression, and prolonged (≥31 days) deployment-related exposures to smoke from oil well fires and chemical nerve agents compared to veterans with unimpaired and intermediate cognitive status. We also replicated our previous finding of hippocampal atrophy in veterans with MCI, and found significant group differences in lateral ventricle volumes.DiscussionBecause MCI increases the risk for late-life dementia and impacts quality of life, it may be prudent to counsel GW veterans with cognitive dysfunction, CMI, history of depression, and high levels of exposures to deployment-related toxicants to adopt lifestyle habits that have been associated with lowering dementia risk. With the Food and Drug Administration’s recent approval of and the VA’s decision to cover the cost for anti-amyloid β (Aβ) therapies, a logical next step for this research is to determine if GW veterans with MCI have elevated Aβ in their brains.https://www.frontiersin.org/articles/10.3389/fnins.2023.1301066/fullcognitionmild cognitive impairmentGulf Warneuropsychologyhippocampusneuroimaging |
| spellingShingle | Linda L. Chao Linda L. Chao Linda L. Chao Kimberly Sullivan Maxine H. Krengel Ronald J. Killiany Lea Steele Nancy G. Klimas Nancy G. Klimas Bang-Bong Koo The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up study Frontiers in Neuroscience cognition mild cognitive impairment Gulf War neuropsychology hippocampus neuroimaging |
| title | The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up study |
| title_full | The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up study |
| title_fullStr | The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up study |
| title_full_unstemmed | The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up study |
| title_short | The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up study |
| title_sort | prevalence of mild cognitive impairment in gulf war veterans a follow up study |
| topic | cognition mild cognitive impairment Gulf War neuropsychology hippocampus neuroimaging |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1301066/full |
| work_keys_str_mv | AT lindalchao theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT lindalchao theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT lindalchao theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT kimberlysullivan theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT maxinehkrengel theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT ronaldjkilliany theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT leasteele theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT nancygklimas theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT nancygklimas theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT bangbongkoo theprevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT lindalchao prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT lindalchao prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT lindalchao prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT kimberlysullivan prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT maxinehkrengel prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT ronaldjkilliany prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT leasteele prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT nancygklimas prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT nancygklimas prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy AT bangbongkoo prevalenceofmildcognitiveimpairmentingulfwarveteransafollowupstudy |