Posttraumatic Stress Disorder, Major Depression, and Mild Cognitive Impairment: A Cohort Study of World Trade Center Responders

Details

• Journal Article:
  Psychiatry Research
• Personal Author:
  Mann, Frank D. ; Clouston, Sean A. P. ; Choi, Jaeun ; Hall, Charles B. ; Zeig-Owens, Rachel ; Christodoulou, Christopher ; Fels, Alicia M. ; Fajfer, Matthew D. ; Melendez, Onix A. ; Hennington, Christina M. ; Arneaud, Candace W. ; Zou, Yang Fan ; Fontana, Ashley E. ; Barber, Alissa ; Mueller, Alexandra K. ; Carr, Melissa A. ; Prezant, David J. ; Luft, Benjamin J.
• Description:
  Background: World Trade Center (WTC) responders have elevated risk of posttraumatic stress disorder (PTSD), major depressive episodes (MDEs), and mild cognitive impairment (MCI). In a sample of 337 WTC responders from the Fire Department of the City of New York (FDNY), we estimated the proportion of MCI cases explained by PTSD and MDE. Methods: We fit quasi-Poisson regressions, adjusting for covariates, to estimate risk ratios (RRs) and population-attributable fractions (PAFs), and explored associations between a symptom count and MCI, as well as individual cognitive tests. Measures: PTSD and MDE were diagnosed with the SCID-5. MCI was defined algorithmically using objective testing (HVLT subtests, COWA, SDMT, TMT-A/B), self-reported concern (CFI >0), and excluding severe naming impairment. The cohort was predominantly firefighters; occupational requirements preserve activities of daily living. Results: PTSD (RR=1.90, 95 % CI = [1.53-2.36]), MDE (RR=1.62, 95 % CI = [1.16-2.27]), and comorbid PTSD/MDE (RR=2.31, 95 % CI = [1.74-3.06]) conferred higher risk of MCI. The combined PAF for PTSD, MDE, and their comorbidity was 11.7 % (95 % CI = [6.1 %-18.1 %]). Symptom burden was associated with higher MCI risk (RR = 1.11, 95 % CI = [1.08-1.14]), and worse visuospatial learning/recall and verbal recognition (p range = [-0.13 to -0.20]). Conclusion: Over 20 years after the precipitating trauma, PTSD, MDE, and their comorbidity accounted for a meaningful share of MCI cases, although most cases (>85 %) were not attributable to these disorders. Findings highlight visuospatial learning and memory as most strongly linked to psychiatric symptoms in this cohort.
• Subjects:
  Cognition Depression Occupational Health Safety September 11 Terrorist Attacks Stress Disorders, Post-Traumatic
• Keywords:
  Author Keywords: PTSD; Depression; Mild Cognitive Impairment; Prevalence Post-traumatic Stress Disorder; PTSD; World Trade Center; WTC; Mental Health; Cognitive Function; Cohort Studies; Emergency Responders; Fire Fighters; Epidemiology;
• Source:
  Psychiatry Res 2026 Jan; 355:116827
• ISSN:
  0165-1781
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; New York City Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  10 pdf pages
• Volume:
  355
• NIOSHTIC Number:
  nn:20071507
• Contact Point Address:
  Frank D. Mann, Department of Medicine, Health Sciences Center, Room 071, 101 Nicolls Road, Stony Brook, NY, USA, 11794
• Email:
  frank.mann@stonybrookmedicine.edu
• Federal Fiscal Year:
  2026
• Performing Organization:
  State University of New York at Stony Brook
• Peer Reviewed:
  True
• Start Date:
  20210701
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:318e73f8b1bf3c037670310fc9b21a851c1ccfa7259c186723dcf9d51155059d6cf0d30cfc0372ce4b87cb69f9470246cf68664e091239be5a5c69b10d1c0ac2
• Download URL:
  https://stacks.cdc.gov/view/cdc/259104/cdc_259104_DS1.pdf
• File Type:
  [PDF - 1.55 MB ]