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Post-traumatic Stress Disorder as a Risk Factor for Dementia: A Systematic Review and Meta-Analysis

Günak, MM; Billings, J; Carratu, E; Marchant, NL; Favarato, G; Orgeta, V; (2020) Post-traumatic Stress Disorder as a Risk Factor for Dementia: A Systematic Review and Meta-Analysis. The British Journal of Psychiatry , 217 (5) pp. 600-608. 10.1192/bjp.2020.150. Green open access

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Abstract

Background: Post-traumatic stress disorder (PTSD) has been identified as a potential risk factor for developing dementia. There are currently, however, no meta-analyses quantifying this risk. Aims: To systematically review and quantify the risk of future dementia associated with PTSD across populations. PROSPERO registration number CRD42019130392. Method: We searched nine electronic databases up to 25 October 2019 for longitudinal studies assessing PTSD and risk of dementia. We used random- and fixed-effects meta-analyses to pool estimates across studies. Results: PTSD was associated with a significant risk for all-cause dementia: pooled hazard ratio HR = 1.61 (95% CI 1.43–1.81, I2 = 85.8%, P < 0.001; n = 1 693 678; 8 studies). Pooled HR was 1.61 (95% CI 1.46–1.78; I2 = 80.9%, P < 0.001; n = 905 896; 5 studies) in veterans, and 2.11 (95% CI 1.03–4.33, I2 = 91.2%, P < 0.001; n = 787 782; 3 studies) in the general population. The association between PTSD and dementia remained significant after excluding studies with high risk of bias (HR = 1.55, 95% CI 1.39–1.73, I2 = 83.9%, P < 0.001; n = 1 684 928; 7 studies). Most studies included were retrospective and there was evidence of high heterogeneity. Conclusions: This is the first meta-analysis quantifying the association of PTSD and risk of dementia showing that PTSD is a strong and potentially modifiable risk factor for all-cause dementia. Future studies investigating potential causal mechanisms, and the protective value of treating PTSD are needed.

Type: Article
Title: Post-traumatic Stress Disorder as a Risk Factor for Dementia: A Systematic Review and Meta-Analysis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1192/bjp.2020.150
Publisher version: https://doi.org/10.1192/bjp.2020.150[Opens in a ne...
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Post-traumatic stress disorder, dementia, risk, systematic review, meta-analysis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10105808
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