Several
studies have investigated the risk of dementia in posttraumatic stress
disorder (PTSD) using a varying methodology. Epidemiological studies
have found an increased risk of dementia with PTSD in Vietnam veterans
as well as the general population. Laboratory studies reported the
accelerated formation of β-amyloid and tau, which represent the primary
pathology of Alzheimer’s dementia in animal models of PTSD. These
investigations were conducted against a background of cognitive
impairment and atrophy of the hippocampus and certain cortical areas in
patients with PTSD. Very few studies have investigated the pathological
basis in humans for the reported association of PTSD with dementia. This
important gap in the literature has recently been partly addressed by
very few studies that estimated the burden of β-amyloid and tau. The PET
studies did not show an association between PTSD and the specific
pathology of Alzheimer’s disease or signs of neurodegenerative diseases
underlying other dementia syndromes. Another study demonstrated
decreased plasma β-amyloid load and increased plasma β-amyloid 42/40
ratio in PTSD without PET evaluation. While PTSD is associated with an
increased risk of dementia syndrome in general, there is no convincing
evidence that it causes or accelerates the pathology of Alzheimer’s
disease, which causes the most common type of dementia. Factors that may
account for the association between PTSD and a clinical diagnosis of
dementia are discussed in this review.
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