SAN FRANCISCO - Combat veterans with post-traumatic stress disorder are more likely to have dementia, cardiac problems and structural changes in the brain as they get older than veterans without PTSD, according to new research.
The findings, which for the most part resulted from research at the San Francisco Veterans Affairs Medical Center, raise concerns about the overall health of aging veterans, but hold promise for the potential of helping to treat these diseases.
"Our concern is that veterans who honorably serve our country ... are at greater risk of developing Alzheimer's disease and over the next 10 to 20 years we will see a lot of Alzheimer's in the veteran population," said Dr. Michael Weiner, director of the institution's Center for Imaging of Neurodegenerative Diseases.
The impact of combat on the aging brain was the focus of Thursday's fourth annual "Brain at War" conference in San Francisco.
Much of the research presented during the daylong conference was conducted at the city's VA hospital and funded through San Francisco's Northern California Institute for Research and Education, the nation's leading neuroscience research institute.
Of the 2 million Americans who've served in the current wars in Iraq and Afghanistan, at least 400,000 -- or as much as 20 percent -- have developed or are at risk of developing PTSD, a psychological condition caused by exposure to severe trauma.
Some 23 million veterans will face more common illnesses, such as cancer, heart disease and Alzheimer's, as a function of aging. A growing body of work shows traumatic stress may exacerbate these diseases, the researchers found.
For example, veterans with PTSD are two to three times more likely to develop heart disease than those who do not have the disorder.
"These are young men and women, most of whom do not yet have heart disease," said Dr. Beth Cohen, a staff physician at the hospital, in a statement about her research. "If we can learn why they are at greater risk now, we can find ways to help avoid heart disease later in life."
No effective ways to prevent or treat Alzheimer's disease yet exist, but researchers are studying soldiers' brains to learn more about how combat-related stress affects the brain's biology and increases the chance of developing Alzheimer's.
They have found that a section of the hippocampus -- the part of the brain devoted to short-term memory and learning new things -- is significantly smaller in veterans with PTSD. Researchers are trying to determine if this smaller section can grow with treatment.
"It's possible new stem cells, new brain cells are made, or it's possible the existing neurons or cells get plumper or have more synapses and connection," said Weiner, also a professor of medicine, radiology, psychiatry and neurology." ... Our ability to probe the brain and understand these mechanisms is really limited."
Weiner and his colleagues at the VA hope their research will help veterans like 37-year-old Ben Sykes, who enlisted in the Marine Corps after Sept. 11, 2001, and was among the first troops to move into Baghdad and then into Saddam Hussein's primary palace in Tikrit in 2003.
When Sykes returned to civilian life and his previous career as a Web designer, he found himself trying to re-create the intensity of combat through drinking and extreme sports.
Sykes did not recognize his classic symptoms of PTSD until his family pushed him to get help. Now, after years of therapy and treatment at the VA, Sykes believes he has few lingering effects other than an occasional feeling of impending panic that comes when he smells burning odors or realizes he's seated with his back to a door.
Still, he is grateful for how far he's come and appreciates the VA's research on the health effects of PTSD.
"Humans are amazing in the sense they adapt to anything," he said.
Research at San Francisco's VA center has led to new information about:
- PTSD and heart disease. Veterans of the current wars in Iraq and Afghanistan who have been diagnosed with PTSD and other mental health issues have two to three times the rate of heart disease risk factors compared with veterans without those diagnoses.
- PTSD and the hippocampus. Research using magnetic resonate imaging, or MRI, at the VA hospital have shown the hippocampus, the part of the brain that stores memory, is significantly smaller in the brains of veterans with PTSD.
- PTSD and dementia. Older veterans with PTSD are almost twice as likely as veterans without such trauma to develop dementia.