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New Study Shows 9-11 Responders Show Cognitive Problems

Sep 1, 2016

New research from a Stony Brook University group has found cognitive impairment in a significant proportion of first responders during the 9/11 World Trade Center attacks.

In the years since the attacks, public attention has focused largely on the cancers and respiratory conditions that have afflicted first responders, Newsday reports. But during this time, mental-health disorders have also been developing, researchers reported in the journal Alzheimer’s & Dementia: Diagnosis, Assessment and Disease Monitoring. Cognitive impairment is a leading risk factor for Alzheimer’s disease and other forms of dementia.

Cognitive impairment refers to poor memory and concentration, including an inability to learn new information. Many people with cognitive impairment have difficulty with the routine activities of daily living. Those who are severely affected ultimately develop full-blown dementia, experts say.

After a traumatic experience, a range of reactions is normal. But for people with PTSD (post-traumatic stress disorder) the reactions can last for months or even years. Symptoms vary but many people with PTSD experience repeated flashbacks of the event, bad dreams, and frightening thoughts. Some experts believe that such re-experiencing might be an early marker of mental pathology.

During the World Trade Center attacks on September 11, 2001, police, firefighters, emergency medical technicians, and other responders experienced a range of traumas, along with exposure to toxins. According to the Stony Brook researchers, about 20 percent of these responders subsequently developed PTSD.

In 2002, the Centers for Disease Control and Prevention (CDC) began a monitoring and treatment program for WTC responders. More than 33,000 individuals have enrolled in the WTC Health Program.

Newsday reports that virtually all of the first responders in the Stony Brook study - 818 in all - live on Long Island. Close to 13 percent (104) had definite evidence of cognitive impairment and 1.2 percent (10 people) already had possible dementia, the study showed. The study was conducted from January 2014 to April 2015.

Sean A. Clouston, assistant professor of public health and lead investigator of the study, said the responders undergoing mental health testing through the Stony Brook University World Trade Center Wellness Program were exceptionally young to have signs of cognitive impairment, which is usually diagnosed in the elderly. The average age of responders during the study was 53, Clouston said.

Cognitive impairment can begin in midlife but is most often diagnosed at older ages, usually in the 70s and later, according to the Cognitive Aging Laboratory at the University of Virginia.

The Stony Brook researchers say the impairment is most evident among responders who suffered post-traumatic stress disorder, a condition often diagnosed in veterans who have experienced war tragedies. PTSD was not the only risk factor for cognitive impairment, Newsday reports. Responders who had a history of major depression were also at risk of being cognitively impaired.

Dr. Heather Snyder, senior director of medical and scientific operations at the Alzheimer’s Association in Chicago, said the research raises an important issue: “We need to start thinking about how PTSD changes the brain.”

Clouston said 9/11 responders with mental health concerns face a problem with lack of funding for these conditions under the Zadroga Act. The Zadroga Act, named for James Zadroga, the first NYPD officer whose death was attributed to toxic exposure at Ground Zero, provides monitoring, treatment and compensation for responders and area survivors who have cancers and other ailments attributed to 9/11 toxins. The December 2015 reauthorization of the Zadroga Act extends the World Trade Center Health Program through 2090.

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