Few studies have examined whether UK military veterans are at an increased risk of dementia. We explored the risk of dementia in Scottish military veterans aged up to 73 years in comparison with people who have never served.

Retrospective cohort study of 78 000 veterans and 253 000 people with no record of service, matched for age, sex and area of residence, with up to 37 years follow-up, using Cox proportional hazard analysis to compare risk of dementia in veterans and non-veterans, overall and by subgroup.

Dementia was recorded in 0.2% of both veterans and non-veterans overall, Cox proportional hazard ratio 0.98, 95% confidence interval (CI) 0.82–1.19, p = 0.879 (landmark age: 50 years), with no difference for men but increased risk in veteran women and Early Service Leavers. Post-traumatic stress disorder (PTSD) was associated with a higher risk of dementia in both veterans and non-veterans, although possibly to a lesser degree in veterans. A history of mood disorder was strongly associated with developing dementia, greater in veterans than in non-veterans, odds ratio 1.54, 95% CI 1.01–2.35, p = 0.045.

There was no evidence to suggest that military service increased the risk of dementia, although this may change as the cohort ages. The well-documented association with PTSD shows no evidence of being stronger in veterans; by contrast, the association of mood disorder with dementia is much stronger in veterans. Healthcare providers should carefully assess the cognitive status of older veterans presenting with depressive illness in order to identify early dementia and ensure optimum management.

很少有研究调查英国退伍军人患痴呆症的风险是否增加。我们将 73 岁以下苏格兰退伍军人与从未服过兵役的人进行比较，探讨了患痴呆症的风险。

对 78 000 名退伍军人和 253 000 名没有服役记录的人进行回顾性队列研究，匹配年龄、性别和居住地区，随访长达 37 年，使用 Cox 比例风险分析比较退伍军人和非退伍军人患痴呆症的风险- 退伍军人，整体和分组。

总体而言，退伍军人和非退伍军人中有 0.2% 的人患有痴呆症，Cox 比例风险比为 0.98，95% 置信区间 (CI) 0.82–1.19，p = 0.879（里程碑年龄：50 岁），男性没有差异，但有所增加退伍军人妇女和早期服务离职者的风险。创伤后应激障碍 (PTSD) 与退伍军人和非退伍军人患痴呆症的风险较高有关，尽管退伍军人的程度可能较低。情绪障碍史与痴呆症的发展密切相关，退伍军人的患病率高于非退伍军人，比值比为 1.54，95% CI 1.01–2.35，p = 0.045。

没有证据表明服兵役会增加患痴呆症的风险，尽管这可能会随着队列年龄的增长而改变。有据可查的与创伤后应激障碍的关联没有显示退伍军人变得更强壮的证据；相比之下，情绪障碍与痴呆症的关联在退伍军人中更为强烈。医疗保健提供者应仔细评估患有抑郁症的老年退伍军人的认知状态，以便识别早期痴呆症并确保最佳管理。