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To examine the role of subjective cognitive difficulties (SCD), posttraumatic stress disorder (PTSD), and their interaction in predicting suicidal ideation and current suicidal intent in middle-aged and older United States (US) military veterans.
Population-based cross-sectional study.
Setting and participants
Data were analyzed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 3602 US veterans aged 50 years and older (mean age = 69.0).
Questionnaires including the Medical Outcomes Study Cognitive Functioning Scale (SCD), PTSD Checklist for DSM-5 (PTSD), Patient Health Questionnaire-9 (suicidal ideation in the previous two weeks), and the Suicide Behaviors Questionnaire-Revised (current suicidal intent).
A total of 154 (4.4%) veterans screened positive for current PTSD, 239 (6.7%) reported past two-week suicidal ideation, and 37 (1.0%) reported current suicidal intent. The probability of suicidal ideation among veterans with both SCD and PTSD was more than six times higher than that observed in the full sample (44.5% vs. 6.7%) and more than 2.5 times higher than that observed in veterans with SCD and no PTSD (44.5% vs. 17.5%). Veterans with both subjective memory and concentration difficulties were more likely to report suicidal intent, though the interaction between SCD and PTSD was not significantly associated with suicidal intent.
Middle-aged and older U.S. veterans with subjective cognitive impairment and PTSD report higher rates of suicidal ideation than those with SCD alone. Interventions targeting SCD and PTSD may mitigate suicide risk among middle-aged and older veterans.
Older adulthood is a developmental stage at the end of the lifespan when an individual experiences a number of significant changes in life circumstances. These age-associated events include changes in physical appearance and body composition, which can result in increased vulnerability to both acute and chronic physical illness as well as functional limitations such as decreased mobility and diminished sensory capacities. In addition, older people generally experience numerous losses and stressors, such as moving to a fixed income, increasing expenses, and loss of retirement investments; death of family members, friends and loss of social network; alterations in social position; changes in housing and work; and spousal caregiving and widowhood. The ability to adapt positively to these types of stressful life event and to other adversities is likely an important factor in “successful” aging.
Currently, older adults are among the fastest growing subgroups of the population in the USA as in many other countries. Recent estimates suggest that there are approximately 37 million people aged 65 years and over in the USA, accounting for over 12% of the total population (US Federal Interagency Forum on Aging-Related Statistics, 2008). By the year 2030, the number of individuals age 65 years and over is expected to nearly double to 71.5 million, accounting for approximately 20% of the US population (US Federal Interagency Forum on Aging-Related Statistics, 2008).
This chapter focuses on the prevalence and etiology of anxiety disorders, including posttraumatic stress disorder (PTSD), following disasters. Recently a number of large national mental health surveys have estimated the prevalence of psychiatric disorders. The anxiety disorders that have been associated with disasters are generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), social phobia, and specific phobia. The discussion of these matters is influenced by the fact that the conventions for recording patterns of comorbidity have changed between Diagnostic and Statistical Manual (DSM)-III and DSM-IV. The relationship between PTSD and the associated comorbidities with other anxiety and depressive disorders is important in determining the chronicity of morbidity following disasters. Anxiety disorders other than PTSD have been looked at in more detail in children, in part because of the potential developmental impact of disorders such as separation anxiety.
Early last year, the GenEthics Consortium (GEC)
of the Washington Metropolitan Area convened at George
Washington University to consider a complex case about
genetic testing for Alzheimer disease (AD). The GEC consists
of scientists, bioethicists, lawyers, genetic counselors,
and consumers from a variety of institutions and affiliations.
Four of the 8 co-authors of this paper delivered presentations
on the case. Supplemented by additional ethical and legal
observations, these presentations form the basis for the
Zn deficiency has been shown to reduce host defence drastically. It was of interest to determine the capacity of the residual lymphocytes from Zn-deficient mice to proliferate and produce lymphokines in response to stimulation since there are many Zn-dependent metalloenzymes that might be altered by the deficiency. To address this question, young adult A/J mice were provided Zn-deficient or Zn-adequate diets or restricted amounts of a Zn-adequate diet for 30 d. Splenocytes from moderately or severely Zn- deficient adult A/J mice gave normal proliferative responses and generated adequate interleukin II (IL- 2) activity when stimulated with the mitogen Concanavalin A. However, splenocytes from deficient mice exhibited a higher degree of proliferation (about 150%) and production of IL-2 in response to foreign target cells compared with T-cells prepared from mice provided a Zn-adequate diet. B-cells from deficient mice stimulated in vivo with sheep erythrocytes produced fewer total numbers of plaque-forming cells (PFC) per spleen. Nevertheless, the proportion or number of PFC/106 viable splenocytes and the amounts of IgM and IgG antibody produced per PFC were equivalent to those of adequately-fed and restricted-fed controls. The previously described responses were not significantly affected by whether the level of Zn in the culture medium was adequate or limiting. Based on these tests it appeared that the residual splenic lymphocytes of Zn-deficient mice were able to carry out many fundamental immune processes.
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