title: Posttraumatic Stress Disorder, Antipsychotic Use and Risk of Dementia in Veterans.
abstract: OBJECTIVE
  To examine the risk of dementia associated with posttraumatic stress disorder (PTSD) and the contribution of antipsychotic use to this risk.
  
  
  METHODS
  Retrospective cohort study SETTING: Australia. Administrative claims data from the Australian Government Department of Veterans' Affairs were used.
  
  
  METHODS
  Male Vietnam veterans aged 55 to 65 at baseline (2001-02) with no preexisting dementia diagnosis (N = 15,612).
  
  
  METHODS
  The association between PTSD and dementia was assessed over 12 years of follow-up. Dementia was identified as a hospital diagnosis, dementia record in service disability data, or dispensing of medicines for dementia. Cox-proportional hazards models were used, with age as the time-scale. Results were stratified according to baseline antipsychotic use.
  
  
  RESULTS
  No greater risk of dementia was observed with PTSD. In veterans who received antipsychotics, dementia risk was significantly higher than in those who did not (hazard ratio (HR) = 2.1, 95% confidence interval (CI) = 1.4-3.3). Dementia risk was significantly greater in veterans hospitalized for PTSD who received antipsychotics (HR = 2.2, 95% CI = 1.1-4.6) and veterans without PTSD who received antipsychotics (HR = 4.3, 95% CI = 2.1-8.6) than in those without PTSD with no antipsychotic use.
  
  
  CONCLUSIONS
  Antipsychotic use may be a contributor to dementia risk. These findings should be interpreted with caution because the study design was observational. Further research using prospective study designs in settings where diagnostic data, cognitive function, and disease severity are available are required.
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute, University of South Australia, Adelaide, Australia.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Roughead
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute, University of South Australia, Adelaide, Australia.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Pratt
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute, University of South Australia, Adelaide, Australia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kalisch Ellett
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute, University of South Australia, Adelaide, Australia.
authors.forename: Emmae N
authors.initials: EN
authors.lastname: Ramsay
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute, University of South Australia, Adelaide, Australia.
authors.forename: John D
authors.initials: JD
authors.lastname: Barratt
authors.affiliation: Australian and New Zealand Mental Health Association, Gold Coast, Australia.|Bond University, Gold Coast, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Morris
authors.affiliation: Department of Veterans' Affairs, Canberra, Australia.
authors.forename: Graeme
authors.initials: G
authors.lastname: Killer
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001315:Australia / Q000453:epidemiology; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D014150:Antipsychotic Agents
keywords: antipsychotic; dementia; posttraumatic stress disorder