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Current Alzheimer Research • November 2013<br />

Military risk factors for cognitive decline,<br />

dementia and Alzheimer’s disease<br />

Author information<br />

Veitch DP1, Friedl KE, Weiner MW.<br />

Center for Imaging of Neurodegenerative Diseases<br />

Veterans Medical Center and Departments of<br />

Radiology, Medicine, Psychiatry and Neurology<br />

University of California, San Francisco<br />

San Francisco, CA, USA<br />

michael.weiner@ucsf.edu<br />

Abstract<br />

Delayed neurological health consequences of environmental exposures<br />

during military service have been generally underappreciated. The rapidly<br />

expanding understanding of Alzheimer’s disease (AD) pathogenesis<br />

now makes it possible to quantitate some of the likely long-term<br />

health risks associated with military service. Military risk factors for<br />

AD include both factors elevated in military personnel such as tobacco<br />

use, traumatic brain injury (TBI), depression, and post-traumatic stress<br />

disorder (PTSD) and other nonspecific risk factors for AD including,<br />

vascular risk factors such as obesity and obesity-related diseases (e.g.,<br />

metabolic syndrome), education and physical fitness. The degree of<br />

combat exposure, Vietnam era Agent Orange exposure and Gulf War<br />

Illness may also influence risk for AD. Using available data on the association<br />

of AD and specific exposures and risk factors, the authors<br />

have conservatively estimated 423,000 new cases of AD in veterans by<br />

2020, including 140,000 excess cases associated with specific military<br />

exposures. The cost associated with these excess cases is approximately<br />

$5.8 billion to $7.8 billion. Mitigation of the potential impact of military<br />

exposures on the cognitive function of veterans and management of<br />

modifiable risk factors through specifically designed programs will be<br />

instrumental in minimizing the impact of AD in veterans in the future<br />

decades.<br />

“... the authors have conservatively estimated<br />

423,000 new cases of AD in veterans by 2020,<br />

including 140,000 excess cases associated with specific<br />

military exposures. The cost associated with these excess<br />

cases is approximately $5.8 billion to $7.8 billion.”<br />

http://www.ncbi.nlm.nih.gov/pubmed/23906002

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