Chronic Posttraumatic Stress Disorder and Comorbid Cognitive and Physical Impairments in World Trade Center Responders

Details

• Personal Author:
  Bromet EJ ; Carr M ; Clouston SAP ; Diminich ED ; Kotov R ; Kranidis A ; Kritkos M ; Kuan P ; Luft BJ
• Description:
  Posttraumatic stress disorder (PTSD) has been linked to increased prevalence and incidence of cognitive and physical impairment. When comorbid, these conditions may be associated with poor long-term outcomes. We examined associations between chronic PTSD and symptom domains with cognitive and physical functioning in World Trade Center (WTC) responders nearly 20 years after the September 11, 2001, terrorist attacks. Participants included a cross-sectional sample of 4,815 responders who attended a monitoring program in 2015-2018. Montreal Cognitive Assessment scores less than 23 indicated cognitive impairment (CogI); Short Physical Performance Battery scores 9 or lower on a hand-grip test indicated physical impairment (PhysI). Comorbid cognitive/physical impairment (Cog/PhysI) was defined as having cognitive impairment with at least one objective PhysI indicator. Clinical chart review provided PTSD diagnoses; symptom domains were assessed using the PTSD Checklist. Participants were on average 53.05 years (SD = 8.01); 13.44% had PTSD, 7.8% had CogI, 24.8% had PhysI, and 5.92% had comorbid Cog/PhysI. Multivariable-adjusted multinomial logistic regression demonstrated that Responders with PTSD have more than three times the risk of Cog/PhysI (adjusted RR = 3.29, 95% CI 2.44- 4.44). Domain-specific analyses revealed that emotional numbing symptoms predicted an increased risk of PhysI (adjusted RR = 1.57, 95% CI 1.08-2.28), whereas reexperiencing symptoms were associated with comorbid Cog/PhysI (adjusted RR = 3.96, 95% CI, 2.33-6.74). These results suggest that responders with chronic PTSD may have increased risk of deficits beyond age-expected impairment characterized by the emergence of comorbid Cog/PhysI at midlife. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Mental Health Nervous System Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Cognitive Function Emergency Responders First Responders Mental Health Post-traumatic Stress Disorder PTSD Rescue Workers World Trade Center WTC
• ISSN:
  0894-9867
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  34
• Issue:
  3
• NIOSHTIC Number:
  nn:20061497
• Citation:
  J Trauma Stress 2021 Jun; 34(3):616-627
• Contact Point Address:
  Sean Clouston, Program in Public Health, Renaissance School of Medicine at Stony Brook University, Health Sciences Center #3-071, Stony Brook, New York 11794-8338, USA
• Email:
  sean.clouston@stonybrookmedicine.edu
• Federal Fiscal Year:
  2021
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Traumatic Stress
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:332f17ca8aae1adfbd4bd26af786e9a9766b000c78948aa6bd6c99e4b01bfe4dfb6fb5fe9c9cfe386697623a7af7b85914c16fc623b13ac73cb5dacb5075d2f6
• Download URL:
  https://stacks.cdc.gov/view/cdc/225013/cdc_225013_DS1.pdf
• File Type:
  [PDF - 160.06 KB ]