PREVALENCE OF DEMENTIA AND ASSOCIATED CONDITIONS IN A NATIONAL COHORT OF OLDER FEMALE VETERANS

Veterans are a population at risk for dementia due to elevated general risk factors and exposure to military risk factors; however, few studies have focused on female veterans despite their growing numbers. We sought to characterize the prevalence of dementia, dementia subtypes, and associated conditions in older female veterans. We acquired cross-sectional data on female veterans ages ≥55 who received care in the Veterans Health Administration medical system between 2005-2015 (N=292,093). Dementia diagnoses were defined using ICD-9 codes or dementia medication prescriptions. Medical comorbidities and psychiatric conditions were determined using ICD-9 codes occurring within four years of dementia diagnosis or the last recorded medical encounter for women without dementia. Chi-square analyses were used to compare demographics; differences in psychiatric and medical conditions were examined using generalized linear models (adjusting for demographics). Female veterans were on average 69.4 years old (SD=10.0). 11,485 (3.9%) had dementia, and prevalence increased with age: ages 55-64: 0.8%; ages 65-74: 1.8%, ages 75-84: 9.8%, ages≥85: 13.8%. Of those diagnosed with a subtype (46.5%; participants could have multiple subtypes), 73.3% had Alzheimer's disease, 29.6% vascular dementia, 3.4% dementia with Lewy bodies, and 2.1% frontotemporal dementia. Women with dementia were older, more likely to be White, more educated, and less wealthy (ps<0.01). Of the women with dementia, 70.7% had at least one medical condition, with high prevalence rates found for hypertension, musculoskeletal pain/arthritis, and diabetes (hypertension: 41.6% vs 15.8% in women without dementia, musculoskeletal pain/arthritis: 42.4% vs 20.4%, diabetes: 12.8% vs 6.9%, p<0.01 for all). Women with dementia also had higher psychiatric comorbidity (38.0% vs 16.1%, p<0.01) including depression and posttraumatic stress disorder (depression: 24.5% vs 7.6%, posttraumatic stress disorder: 2.3% vs 1.9%, ps<0.01 for both). This is one of the first known studies to characterize dementia prevalence in female veterans, with prevalence rates expected to increase with impending demographic shifts in the military. The high prevalence rates of medical and psychiatric conditions in female veterans with dementia highlight their healthcare burden and emphasize the need for further investigations into the prevention, treatment, and care of dementia in this understudied population.