Prevalence of Mild and Severe Cognitive Impairment in World Trade Center Exposed Fire Department of the City of New York (FDNY) and General Emergency Responders.

Details

• Alternative Title:
  American Journal of Industrial Medicine, 2025, v. 68, no. 2: Prevalence of Mild and Severe Cognitive Impairment in World Trade Center Exposed Fire Department of the City of New York (FDNY) and General Emergency Responders.
• Journal Article:
  American Journal of Industrial Medicine
• Personal Author:
  Mann, Frank D. ; Mueller, Alexandra K. ; Zeig-Owens, Rachel ; Choi, Jaeun ; Prezant, David J. ; Carr, Melissa M. ; Fels, Alicia M. ; Hennington, Christina M. ; Armstrong, Megan P. ; Barber, Alissa ; Fontana, Ashley E. ; Kroll, Cassandra H. ; Chow, Kevin ; Melendez, Onix A. ; Smith, Abigail J. ; Luft, Benjamin J. ; Hall, Charles B. ; Clouston, Sean A. P.
• Description:
  The emergency personnel who responded to the World Trade Center (WTC) attacks endured severe occupational exposures, yet the prevalence of cognitive impairment remains unknown among WTC-exposed-FDNY-responders. The present study screened for mild and severe cognitive impairment in WTC-exposed FDNY responders using objective tests, compared prevalence rates to a cohort of non-FDNY WTC-exposed responders, and descriptively to meta-analytic estimates of MCI from global, community, and clinical populations.
  
  A sample of WTC-exposed-FDNY responders (n = 343) was recruited to complete an extensive battery of cognitive, psychological, and physical tests. The prevalences of domain-specific impairments were estimated based on the results of norm-referenced tests, and the Montreal Cognitive Assessment (MoCA), Jak/Bondi criteria, Petersen criteria, and the National Institute on Aging and Alzheimer's Association (NIA-AA) criteria were used to diagnose MCI. NIA-AA criteria were also used to diagnose severe cognitive impairment. Generalized linear models and propensity score matching were used to compare prevalence estimates of cognitive impairment to a large sample of WTC-exposed-non-FDNY responders from the General Responder Cohort (GRC; n = 7102) who completed the MoCA during a similar time frame.
  
  Among FDNY responders under 65 years, the unadjusted prevalence of MCI varied from 52.57% to 60.32% depending on the operational definition of MCI, apart from using a conservative cut-off applied to MoCA total scores (18 < MoCA < 23), which yielded a markedly lower crude prevalence (24.31%) compared to alternative criteria. Using propensity score matching, the prevalence of MCI was significantly higher among WTC-exposed FDNY responders, compared to WTC-exposed GRC responders (adjusted RR = 1.13 (CI 95% = 1.07-1.20, p < 0.001), and descriptively higher than meta-analytic estimates from different global, community, and clinical populations. Following NIA-AA diagnostic guidelines, 4.96% of WTC-exposed-FDNY-responders met the criteria for severe impairments (95% CI = 2.91-7.82), a prevalence that remained largely unchanged after excluding responders over the age of 65 years.
  
  There is a high prevalence of mild and severe cognitive impairment among WTC-responders, highlighting the putative role of occupational, environmental, and disaster-related exposures in the etiology of accelerated cognitive decline.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • September 11 Terrorist Attacks
  • Cognitive Dysfunction
  • Prevalence
  • Male
  • Emergency Responders
  • Female
  • Middle Aged
  • Adult
  • Occupational Exposure
  More +
• Source:
  American Journal of Industrial Medicine, 2025, v. 68, no. 2
• DOI:
  https://doi.org/10.1002/ajim.23685
• ISSN:
  0271-3586 ; 1097-0274
• Pubmed ID:
  39674910
• Pubmed Central ID:
  PMC12175152
• Document Type:
  Text
• Funding:
  R21 AG074705/AG/NIA NIH HHSUnited States/ ; U01 OH012258/OH/NIOSH CDC HHSUnited States/ ; UM1 TR004400/TR/NCATS NIH HHSUnited States/ ; R01 AG049953/AG/NIA NIH HHSUnited States/ ; This research was supported by the National Institute for Occupational Safety and Health. This study was supported by the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health (1U01OH0122580100 and 75D301-22-C-15522) and the National Institute of Health/National Institute on Aging (R01 AG049953)./
• Genre:
  Journal Article
• Place as Subject:
  New York City
• Pages in Document:
  160-174 (25 pdf pages)
• Volume:
  68
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/261857/cdc_261857_DS1.pdf
• File Type:
  [PDF - 1.25 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:e72fc22b8d09dd2ac4de5e17ae6174fca260ad8ec0fe9f1784d02c2ef38fd23964c75f0f884977fdaad7123bb0d1e04945fdcf9d83a7dbff0233a2ae9539b251