ABSTRACT

Background: Post Traumatic Stress Disorder (PTSD) has been described as an independent risk factor for cognitive decline and dementia. At the same time, cognitive deterioration and increased loss experiences in dementia may increase liability for the reactivation of traumatic memories and thereby PTSD symptoms.

Objective: In order to investigate co-occurrence of PTSD in dementia this systematic literature review summarizes all the available evidence on reported comorbidity rates of PTSD in patients with dementia.

Method: PubMed, Embase, PsycINFO and CINAHL were searched for potential publications investigating the co-occurrence of PTSD in dementia until 25 November 2019. Cohort and cross-sectional studies were included. To assure current comorbidity of PTSD in dementia, only publications with a recent PTSD diagnosis (<2 years before onset of dementia) were selected.

Results: Of the 860 identified abstracts, three studies (0.35%) met the eligibility criteria and were included. These three studies concerned only military veteran populations, and they comprised two cross-sectional cohort studies and one prospective cohort study. The estimated comorbidity rate of PTSD in veterans with dementia varied between 4.7% and 7.8%.

Conclusions: The limited research available shows comorbidity rates only in military veterans, which were possibly dependent on investigated population with respect to dementia severity and possibly associated behavioural and psychiatric symptoms of dementia (BPSD). In dementia patients the comorbidity with PTSD may be high and we suggest that worldwide the impact of PTSD in dementia is high and probably underestimated. Research and care on this topic should improve urgently with the current expanding prevalence of dementia. A first step to improve quality of dementia research and care would be to develop a structured tool to diagnose PTSD in these patients.

摘要

背景：创伤后应激障碍 (PTSD) 已被描述为认知能力下降和痴呆的独立危险因素。与此同时，痴呆症患者的认知能力下降和丧失经历增加可能会增加创伤记忆重新激活的可能性，从而增加 PTSD 症状。

目的：为了调查 PTSD 在痴呆症中的共同发生，本系统的文献综述总结了关于报告的痴呆症患者 PTSD 合并症率的所有可用证据。

方法：在 PubMed、Embase、PsycINFO 和 CINAHL 中搜索了截至 2019 年 11 月 25 日调查 PTSD 在痴呆症中同时发生的潜在出版物。队列研究和横断面研究均包括在内。为了确保 PTSD 在痴呆症中的当前合并症，仅选择了近期诊断为 PTSD（痴呆症发作前 <2 年）的出版物。

结果：在 860 份确定的摘要中，三项研究 (0.35%) 符合资格标准并被纳入。这三项研究仅涉及退伍军人人群，包括两项横断面队列研究和一项前瞻性队列研究。患有痴呆症的退伍军人中 PTSD 的估计合并症发生率在 4.7% 到 7.8% 之间变化。

结论：可用的有限研究显示仅在退伍军人中存在合并症率，这可能取决于调查人群的痴呆症严重程度以及可能相关的痴呆症行为和精神症状 (BPSD)。在痴呆症患者中，PTSD 的合并症可能很高，我们认为在全世界范围内，PTSD 对痴呆症的影响很大，而且可能被低估了。随着当前痴呆症患病率的不断扩大，对这一主题的研究和护理应得到迫切改善。提高痴呆症研究和护理质量的第一步是开发一种结构化工具来诊断这些患者的 PTSD。