Dementia, a progressive decline in cognitive function, is common among older adults. As many as half of all people over the age of 85 are thought to have some form of dementia, and some groups may be at higher risk than others. Military service is associated with specific risks that may increase a person’s likelihood of developing dementia later in life.
If you or someone you know has served in the military, it’s important to be aware of the factors that can contribute to cognitive decline. Carers of people with dementia may also benefit from the resources available for veterans’ dementia care.
The Link Between Military Service and Dementia Risk
Military veterans with post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) have a higher risk of dementia than the general population. Read on to learn how PTSD and TBI can affect brain function and contribute to cognitive decline in later life.
PTSD and Dementia: Understanding the Connection
Post traumatic stress disorder (PTSD) is more common among veterans than the general population, due to the often-traumatic nature of the job. PTSD commonly occurs when someone experiences a life-threatening event, and it has a profound effect on cognitive and mental health. Traumatic stress is also thought to cause changes in brain structure and function, which play a critical role in memory.
PTSD is thought to double a person’s risk of dementia in veterans and the general population. The exact reason for this isn’t understood, but researchers think it may be related to hypervigilance and the effects of chronic stress on the brain. Other lifestyle factors linked to PTSD, such as poor quality sleep and social withdrawal, may also contribute to cognitive decline.
Impact of Combat and Trauma on Dementia Risk
Head injuries and traumatic brain injury (TBI) are prevalent among military veterans, and this may increase their risk of dementia. Studies suggest that dementia risk increases with the severity of TBI, likely as a result of the damage to brain structure.
Not every incidence of TBI increases dementia risk, and there is no evidence that a single mild TBI can cause cognitive decline. However, moderate-to-severe TBI, or repeated mild TBIs, can make veterans more likely to develop dementia in later life.
TBIs can also have severe consequences for many other aspects of mental health. Moderate-to-severe TBIs have been associated with personality changes including irritability, severe impulsivity, and loss of interest in everyday life. Even mild TBIs can increase a person’s risk of suicidality, PTSD, and major depression.
Recognizing Dementia Symptoms in Veterans
Dementia is a progressive condition that starts mild and gets worse over time. You may notice several symptoms relating to cognitive function, including:
- Memory loss
- Problems with communication
- Trouble with visual and spatial skills (such as getting lost while driving)
- Problems with problem-solving
- Difficulty performing complex tasks
- A decline in planning and organizational skills
- Poor coordination
- Confusion
- Disorientation
Many veterans and other people with dementia also experience psychological symptoms, such as:
- Personality changes
- Depression and anxiety
- Irritability
- Inappropriate behavior
- Paranoia
- Hallucinations
If you notice memory changes in yourself or someone you know, see a doctor as soon as possible. There is no cure for dementia, but early diagnosis can mean more treatment options and a greater likelihood of finding treatment that helps.
Dementia Care Options for Veterans
People with dementia often have complex needs, especially as the disorder becomes more advanced. Many people living with dementia receive care at home, often from a family member. However, people with late-stage dementia may need the full-time assistance and medical expertise that can only be provided by a nursing home.
If you know a veteran with dementia, learning more about the resources and support services available can help you access the best care for your loved one. The U.S Department of Veterans Affairs (VA) offers a variety of programs to honor and support veterans and their families, and there are many more places you can go for guidance.
Veterans Memory Care Services
People with advanced dementia typically require help with most or all daily tasks including dressing, eating, and personal care. This can be challenging for caregivers and, often, people experiencing the late stages of dementia may need full-time care in a nursing home. If you are supporting a veteran with dementia and are unsure how to handle their care, the Alzheimer’s Association has a helpline where you can access advice and support.
VA Health Care Benefits for Dementia Care
Veterans with dementia may benefit from the healthcare services provided by the U.S. Department of Veterans Affairs (VA). The services provided depend on the individual’s needs, but may include:
- Home based primary care
- Homemaker and home health aide
- Respite care
- Adult day health care
- Nursing home
- Palliative care
- Hospice care
VA also provides caregiver support services for those looking after people with dementia.
Community and Nonprofit Support Resources
Caring for someone with dementia can be challenging, and caregivers can often benefit from additional support. The Alzheimer’s Association Community Resource Finder is a helpful tool for seeking out support services, and ALZ Connected has a helpline where you can access information and guidance.
Other organizations that offer resources for carers of veterans with dementia include:
- The National Institutes of Aging (NIA)
- The Administration for Community Living (ACL)
- The Centers for Disease Control and Prevention (CDC)
- Medline Plus
- The National Institute of Neurological Disorders and Strokes (NINDS)
Practical Tips for Caregivers Supporting Veterans with Dementia
People living with dementia require different types of care, depending on the stage of the illness and the severity of their symptoms. Understanding the key dementia stages and symptoms and the common behaviors of people with dementia can help carers navigate these challenges, but accessing support is also key for preventing caregiver burnout.
Coping Strategies for PTSD and Dementia in Caregiving
PTSD is common among veterans, and traumatic stress can increase a person’s risk of developing dementia in later life. Cognitive decline can make PTSD symptoms worse or cause a resurgence in PTSD symptoms. Often, PTSD symptoms such as flashbacks, hypervigilance, hyperactivity, and nightmares are mistaken for the behavioral symptoms of dementia. Therefore, a proper understanding of PTSD symptoms in veterans with dementia is key for more tailored and effective treatment.
Addressing and managing PTSD symptoms in veterans’ dementia care
Veterans with trauma and dementia may require an in-depth assessment to properly assess their symptoms and formulate a suitable treatment plan. Studies have found that people with both PTSD and dementia may benefit from PTSD treatments such as:
- Eye movement desensitization and processing (EMDR)
- Cognitive behavioral therapy (CBT)
- Prolonged exposure therapy (PE)
- Pharmacological treatments (such as antidepressant medication)
Self-care tips for caregivers
PTSD and dementia can cause a complex array of symptoms that make life challenging for patients and their carers. Caregivers of veterans with dementia may struggle to make time for their own self-care, but taking on too much can lead to caregiver burnout Burnout is heavily associated with anxiety and depression which, left untreated, can have a heavy impact on quality of life. Therefore, it’s vital that those providing support for veterans with dementia find time to focus on their own health and well-being.
Navigating Veterans Benefits and Support Services
If you provide dementia care for a veteran, you may want to look into VA benefits for dementia patients. Their VA Family Caregiver service can support veterans memory care by assisting family members with their health, well-being, personal needs, and safety. These services can ease the pressure on the veteran’s primary caregivers and provide them with opportunities to practice self-care, making it easier to enjoy the positive aspects of caring for a loved one with dementia.
You can apply for caregiver assistance online through the VA website, or by mail. You can also call their Caregiver Support Line for more information and guidance.
Conclusion
Dementia is prevalent among older adults worldwide, and rates are expected to increase as our population ages. PTSD and TBIs can contribute to cognitive decline and, as people with higher rates of both, veterans may be more likely to develop dementia than the general population. Trauma and dementia can cause overlapping symptoms, and symptoms of PTSD are often mistaken for those of dementia. Therefore, veterans' dementia care should take both conditions into account if they are to receive effective treatment.
The U.S. Department of Veterans Affairs has a variety of programs dedicated to supporting veteran mental health and the families of those with dementia. To learn more about dementia resources for veterans, you can call the VA Caregiver Support Line at 1-855-260-3274.
References
1 https://www.ninds.nih.gov/health-information/disorders/dementias
2 https://www.alz.org/help-support/resources/veterans-dementia
3 https://www.ptsd.va.gov/understand/common/common_veterans.asp
4 https://pmc.ncbi.nlm.nih.gov/articles/PMC3181836/#sec10
5 https://www.ucl.ac.uk/news/2020/sep/ptsd-may-double-risk-dementia
6 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815180
7 https://www.ncbi.nlm.nih.gov/books/NBK539387/
8 https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/traumatic-brain-injury
9 https://pmc.ncbi.nlm.nih.gov/articles/PMC8849136/
10 https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013
11 https://www.va.gov/geriatrics/pages/Alzheimers_and_Dementia_Care.asp
12 https://www.communityresourcefinder.org/
14 https://www.alzheimers.gov/life-with-dementia/resources-caregivers
15 https://alwayshomeconnected.com/blogs/news/dementia-stages
16 https://alwayshomeconnected.com/blogs/news/common-behaviours-of-dementia
17 https://onlinelibrary.wiley.com/doi/10.1111/psyg.12549
18 https://onlinelibrary.wiley.com/doi/10.1111/psyg.12951
19 https://my.clevelandclinic.org/health/diseases/9225-caregiver-burnout
21 https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00249-8/fulltext
22 https://www.caregiver.va.gov/help_landing.asp