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PTSD linked to accelerated cognitive decline in women



Roberts reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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PTSD was associated with accelerated decline in cognitive function in middle-aged women, researchers reported in JAMA Network Open.

“Stress and [PTSD] have been hypothesized to impair learning and memory by biasing attention toward threat and reducing attention to emotionally neutral information, altering brain structures, affecting brain immune function and accelerating Alzheimer disease pathogenesis,” Andrea L. Roberts, PhD, MPH, and colleagues wrote.

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Roberts, a senior research scientist at the Harvard University T.H. Chan School of Public Health, and colleagues aimed to assess the association between PTSD and the decline in cognitive function over time.

The researchers included 12,270 female participants with a mean age of 61.1 years; 95.9% were white. The main outcome was evaluated using a self-administered online cognitive battery. Cognitive function was measured through a psychomotor speed and attention composite score, as well as a learning and working memory composite score.

The participants completed the self-administered cognitive battery every 6 or 12 months for up to 24 months, from October 2014 through July 2019. Linear mixed-effects models were used to assess the association of PTSD symptoms with the rate of change in cognition. The rate of cognitive change was adjusted for potential practice effects.

A higher number of PTSD symptoms were associated with worse cognitive trajectories, the researchers reported. When compared with women with no PTSD symptoms, women with six to seven symptoms had a significantly worse rate of change in both learning and working memory (–0.08; 95% CI, –0.11 to –0.04) and a worse rate for psychomotor speed and attention (–0.05; 95% CI, –0.09 to –0.01).

Associations were unchanged when adjusting for behavioral factors and health conditions. However, associations were partially attenuated but still evident when further adjusted for practice effects (–0.07; 95% CI, –0.11 to –0.03) and comorbid depression (–0.07; 95% CI, –0.11 to –0.03).

“Our findings were consistent with those of previous cross-sectional studies among persons exposed to extreme traumas, including military combat, the Holocaust and childhood sexual abuse,” Roberts and colleagues wrote. “These studies have generally found that persons with PTSD have lower cognitive function than those without PTSD. Moreover, as in our findings, the largest cognitive differences were observed in learning and memory.”

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