Evidence map›Paper›PMID 34626181›Full record

ArticleMilitary medicine2023

Association of Military Employment With Late-Life Cognitive Decline and Dementia: A Population-Based Prospective Cohort Study.

Melinda C Power, Alia E Murphy, Kan Z Gianattasio, Y I Zhang, Rod L Walker, Paul K Crane, Eric B Larson, Laura E Gibbons, Raj G Kumar, Kristen Dams-O'Connor

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Military medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Social determinants of dementia: A scoping review.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Melinda C PowerDepartment of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC 20052, USA.
Alia E MurphyDepartment of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC 20052, USA.
Kan Z GianattasioDepartment of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC 20052, USA.
Y I ZhangDepartment of Statistics, George Washington University Columbian College of Arts and Sciences, Washington, DC 20052, USA.
Rod L WalkerKaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA.ORCID 0000-0002-8464-9805
Paul K CraneDepartment of Medicine, University of Washington, Seattle, WA 98195-6420, USA.
Eric B LarsonDepartment of Medicine, University of Washington, Seattle, WA 98195-6420, USA.
Laura E GibbonsDepartment of Medicine, University of Washington, Seattle, WA 98195-6420, USA.
Raj G KumarDepartment of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Kristen Dams-O'ConnorDepartment of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Milken Institute · USUniversity of Washington · USIcahn School of Medicine at Mount Sinai · USGeorge Washington University · USKaiser Permanente Washington Health Research Institute · US

Funding

THERAPEUTIC EFFECTS OF INTRA-NASAL INSULIN DETEMIRP50AG005136 · NIA · UNIVERSITY OF WASHINGTON · PI GRABOWSKI, THOMAS J. · 1985 to 2019
$57.2M
Furthering scientific understanding of mechanisms underlying resilience to the effects of AD pathology by incorporating state of the art quantification of gliosis, inflammation, & synaptic toxicityU01AG006781 · NIA · UNIVERSITY OF WASHINGTON · PI CRANE, PAUL K, LARSON, ERIC B · 1986 to 2020
$39.3M
University of Washington Alzheimer's Disease Research CenterP30AG066509 · NIA · UNIVERSITY OF WASHINGTON · PI Thomas J. Grabowski · 2020 to 2026
$29.0M
Leveraging Existing Aging Research Networks to investigate TBI and AD/ADRD risk (LEARN TBI & AD)R01AG061028 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI DAMS-O'CONNOR, KRISTEN, MEZ, JESSE BENJAMIN · 2019 to 2023
$5.9M
NIA NIH HHS P30 AG066509NIA NIH HHS P50 AG005136NIA NIH HHS R01 AG061028NIA NIH HHS U01 AG006781
6 · The paper itself

Abstract

introductionAs the number of U.S. veterans over age 65 has increased, interest in whether military service affects late-life health outcomes has grown. Whether military employment is associated with increased risk of cognitive decline and dementia remains unclear. MATERIALS AND

methodsWe used data from 4,370 participants of the longitudinal Adult Changes in Thought (ACT) cohort study, enrolled at age 65 or older, to examine whether military employment was associated with greater cognitive decline or higher risk of incident dementia in late life. We classified persons as having military employment if their first or second-longest occupation was with the military. Cognitive status was assessed at each biennial Adult Changes in Thought study visit using the Cognitive Abilities Screening Instrument, scored using item response theory (CASI-IRT). Participants meeting screening criteria were referred for dementia ascertainment involving clinical examination and additional cognitive testing. Primary analyses were adjusted for sociodemographic characteristics and APOE genotype. Secondary analyses additionally adjusted for indicators of early-life socioeconomic status and considered effect modification by age, gender, and prior traumatic brain injury with loss of consciousness TBI with LOC.

resultsOverall, 6% of participants had military employment; of these, 76% were males. Military employment was not significantly associated with cognitive change (difference in modeled 10-year cognitive change in CASI-IRT scores in SD units (95% confidence interval [CI]): -0.042 (-0.19, 0.11), risk of dementia (hazard ratio [HR] [95% CI]: 0.92 [0.71, 1.18]), or risk of Alzheimer's disease dementia (HR [95% CI]: 0.93 [0.70, 1.23]). These results were robust to additional adjustment and sensitivity analyses. There was no evidence of effect modification by age, gender, or traumatic brain injury with loss of consciousness.

conclusionsAmong members of the Adult Changes in Thought cohort, military employment was not associated with increased risk of cognitive decline or dementia. Nevertheless, military veterans face the same high risks for cognitive decline and dementia as other aging adults.

Indexed as

Alzheimer DiseaseBrain Injuries, TraumaticCognitive DysfunctionAdultAgedCohort StudiesFemaleHumansMaleProspective StudiesUnconsciousness

Identifiers

PMID34626181
PMCPMC10390078
OpenAlexW3202433320

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.