Mental Health Mediators of Subjective Cognitive Concerns Among World Trade Center Responders.

Details

• Alternative Title:
  Journal of Psychiatric Research, 2021, v. 140: Mental Health Mediators of Subjective Cognitive Concerns Among World Trade Center Responders.
• Journal Article:
  Journal of Psychiatric Research
• Personal Author:
  Stein, Cheryl R ; Cooney, Michael L. ; Frank, Brandon ; Bender, Heidi A ; Winkel, Gary ; Lucchini, Roberto G
• Description:
  Decline in cognitive functioning among rescue and recovery workers who responded in the aftermath of the September 11, 2001, World Trade Center (WTC) attacks is of emerging interest. Responders are vulnerable to cognitive decline from exposure to airborne toxins present at the WTC site, as well as from WTC-related mental and physical health conditions. To better understand the relationship between occupational WTC exposure, mental health, physical health and subjective cognitive functioning, we examined the mediating role of health status in the association between exposure and subjective cognitive concerns in a multi-site, longitudinal investigation of the WTC General Responder cohort (n = 16,380 responders; n = 58,575 visits) for the period 2002-2015. Through latent class analyses, we identified a four-level marker of cognitive concerns based on information from a Self-Administered Mental Health Questionnaire. Using generalized linear mixed models with random intercepts, we observed that a higher intensity WTC exposure composite was associated with greater cognitive concerns, and that this association was operating almost entirely through mental health comorbidities, not physical health comorbidities. In fully adjusted models, the inclusion of probable depression, anxiety, PTSD and use of psychotropic medications attenuated the association between highest WTC exposure and greatest cognitive concerns. Physical health did not appear to be on the pathway between WTC exposure and cognitive concerns. Understanding the underlying sources of cognitive concerns may help identify vulnerable members of the General Responder cohort and potentially aid clinical decision-making, such as treatment choice and enhanced screening options. Earlier diagnosis and symptom treatment may help preserve functional independence.
• Content Notes:
  Author manuscript
• Subjects:
  • Cognition
  • Cohort Studies
  • Emergency Responders
  • Humans
  • Mental Health
  • Occupational Exposure
  • September 11 Terrorist Attacks
  • Stress Disorders, Post-Traumatic
• Keywords:
  • September 11 Terrorist Attacks
  • Cognitive Dysfunction
  • Mental Health
  • Epidemiology
  • Occupational Health
• Source:
  Journal of Psychiatric Research, 2021, v. 140
• DOI:
  https://doi.org/10.1016/j.jpsychires.2021.05.081
• ISSN:
  0022-3956 ; 1879-1379
• Pubmed ID:
  34118636
• Pubmed Central ID:
  PMC12666625
• Document Type:
  Text
• Funding:
  U01 OH010988/OH/NIOSH CDC HHSUnited States/ ; U10 OH008216/OH/NIOSH CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  New York City
• Pages in Document:
  187-196 (26 pdf pages)
• Volume:
  140
• Download URL:
  https://stacks.cdc.gov/view/cdc/262144/cdc_262144_DS1.pdf
• File Type:
  [PDF - 1.02 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:513be0fbed67474c319bc878a1fbdd15054bbc6bd729baca793780e8826788a752f959e8ea00d9e950221495cb777b0bb1717b8af6c662b1a4eaa72b3f76113d