On 9/11, a whole generation was traumatized and a cohort of heroes was created who responded to a call to help in the search, rescue, and cleanup efforts in Manhattan. While we understand the current troubles that such individuals face, we have very little knowledge about what they can expect as they age. Yet, these first responders now average age 52 and may already be experiencing rapid aging as 24% report having poor memories and 14% screen positive for mild cognitive impairment, which precedes dementia in over 80% of cases. Responders are not alone in experiencing dementia: as many as 5 million Americans currently live with Dementia, while over 15 million are charged with caretaking responsibilities for friends and family members who are cognitively impaired. One theory that has recently arisen is that severe traumatic experiences, leading to chronic forms of post-traumatic stress, have long-term implications for brain aging. In particular, it is possible tat such traumas severely decrease the ability for the brain to resist injury and to remain healthy. However, to date research has been hampered by small sample sizes and limited opportunity for life course analysis. Preliminary analyses show substantial support for the view that PTSD impacts cognition at baseline and provide support for the view that PTSD may be determined by similar factors influencing resilience as is cognitive aging. Furthermore, preliminary evidence is also suggestive that PTSD is strongly associated with poorer cognition, even in this highly educated and generally employed cohort. The study of aging demands an integrative life course developmental framework, involving interdisciplinary collaborations and advanced methodological approaches for understanding what modifies healthy aging. Taking this into account, this project has four specific aims. First, it will examine the role of individual and socal characteristics in influencing cognitive reserve. Second, it will evaluate the relationship between PTSD and cognitive aging in the WTC first-responder cohort. Third it will examine the biological mechanisms linking PTSD to cognitive aging. Finally, it will examine the social and behavioral mechanisms linking PTSD to cognitive aging.

Public Health Relevance

On September 11th 2001, a whole generation was traumatized. Since then, first responders who helped in the search, rescue, and clean-up efforts have been both celebrated and ultimately subjected to a host of physical and mental health conditions. This proposal is to collect new data about the memory of such responders to examine the extent to which the post-traumatic stress that occurred among more than 20% of responders as a result of their experiences has led to more rapid cognitive aging and an increase in the risk of dementia.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
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Social Psychology, Personality and Interpersonal Processes Study Section (SPIP)
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Roberts, Luci
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State University New York Stony Brook
Public Health & Prev Medicine
Schools of Medicine
Stony Brook
United States
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Clouston, Sean; Pietrzak, Robert H; Kotov, Roman et al. (2017) Traumatic exposures, posttraumatic stress disorder, and cognitive functioning in World Trade Center responders. Alzheimers Dement (N Y) 3:593-602
Clouston, Sean A P; Guralnik, Jack M; Kotov, Roman et al. (2017) Functional Limitations Among Responders to the World Trade Center Attacks 14 Years After the Disaster: Implications of Chronic Posttraumatic Stress Disorder. J Trauma Stress 30:443-452
Clouston, Sean A P; Shapira, Oren; Kotov, Roman et al. (2017) Proton pump inhibitors and the risk of severe cognitive impairment: The role of posttraumatic stress disorder. Alzheimers Dement (N Y) 3:579-583
McGrath, J J; McLaughlin, K A; Saha, S et al. (2017) The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries. Psychol Med 47:1230-1245
McGrath, John J; Saha, Sukanta; Al-Hamzawi, Ali et al. (2016) The Bidirectional Associations Between Psychotic Experiences and DSM-IV Mental Disorders. Am J Psychiatry 173:997-1006
McGrath, John J; Saha, Sukanta; Al-Hamzawi, Ali O et al. (2016) Age of Onset and Lifetime Projected Risk of Psychotic Experiences: Cross-National Data From the World Mental Health Survey. Schizophr Bull 42:933-41
Clouston, Sean A P; Glymour, Maria; Terrera, Graciela Muñiz (2015) Educational inequalities in aging-related declines in fluid cognition and the onset of cognitive pathology. Alzheimers Dement (Amst) 1:303-310