The Role of Mental Health Conditions in Early Detection and Treatment of Veterans With Alzheimer's Dementia

The benefits of early detection of Alzheimer's disease (AD) have become increasingly recognized. Veterans with mental health conditions (MHCs) may be less likely to receive a specific AD diagnosis compared to veterans without MHCs. We investigated whether rates of MHCs differed between veterans...

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Published inMilitary medicine Vol. 189; no. 7-8; p. 1409
Main Authors O'Connor, Maureen K, Aguilar, Byron J, Nguyen, Andrew, Berlowitz, Dan, Zhang, Raymond, Tahami Monfared, Amir Abbas, Zhang, Quanwu, Xia, Weiming
Format Journal Article
LanguageEnglish
Published England 03.07.2024
Subjects
Aged
Aged, 80 and over
Alzheimer Disease - diagnosis
Alzheimer Disease - epidemiology
Cohort Studies
Dementia - diagnosis
Dementia - epidemiology
Early Diagnosis
Female
Humans
Male
Mental Disorders - diagnosis
Mental Disorders - epidemiology
Middle Aged
Retrospective Studies
United States - epidemiology
Veterans - psychology
Veterans - statistics & numerical data
United States
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Summary:The benefits of early detection of Alzheimer's disease (AD) have become increasingly recognized. Veterans with mental health conditions (MHCs) may be less likely to receive a specific AD diagnosis compared to veterans without MHCs. We investigated whether rates of MHCs differed between veterans diagnosed with unspecified dementia (UD) vs. AD to better understand the role MHCs might play in establishing a diagnosis of AD. This retrospective analysis (2015-2022) identified UD and AD with diagnostic code-based criteria. We determined the proportion of veterans with MHCs in UD vs. AD cohorts. Secondarily, we assessed the distribution of UD/AD diagnoses in veterans with and without MHCs. We identified 145,309 veterans with UD and 33,996 with AD. The proportion of each MHC was consistently higher in UD vs. AD cohorts: 41.4% vs. 33.2% (depression), 26.9% vs. 20.3% (post-traumatic stress disorder), 23.4% vs. 18.2% (anxiety), 4.3% vs. 2.1% (bipolar disorder), and 3.9% vs. 1.5% (schizophrenia). The UD diagnostic code was used in 84% of veterans with MHCs vs. 78% without MHCs (P < .001). Mental health conditions were more likely in veterans with UD vs. AD diagnoses; comorbid MHC may contribute to delayed AD diagnosis.
ISSN:1930-613X
DOI:10.1093/milmed/usae161