January 25, 2019

Castro to VA Secretary Wilkie: Does the VA Recognize Links Between PTDS, Alzheimer’s and Dementia?

WASHINGTON—Congressman Joaquin Castro (TX-20), Chairman of the Congressional Hispanic Caucus, a member of the House Foreign Affairs Committee and House Permanent Select Committee on Intelligence, and representative of Military City USA, asked the U.S. Department of Veteran Affairs to provide any information in their possession that relates to the link between Post-Traumatic Stress Disorder (PTSD), Alzheimer’s and dementia. In a letter to Secretary of Veterans Affairs Robert Wilkie, Congressman Castro specifically urged that there is good reason to believe PTSD may be linked with later development dementia, citing U.S. Department of Defense-funded research.

“I recently discussed the link between post-traumatic stress disorder (PTSD) and dementia with a group of veterans in my district. They expressed concern that the Department of Veterans Affairs (VA) does not recognize dementia developed later in life as being a secondary condition of service-connected PTSD,” Chairman Castro wrote.

Chairman Castro continued: “As a Congressman representing much of San Antonio–Military City, USA–I am committed to ensuring that the more than 60,000 veterans who live in my district receive disability rates that accurately reflect both the injuries sustained during their service and secondary conditions developed later in life as a result.”

Full text of the letter follows and can be found here.

January 23, 2019

The Honorable Robert Wilkie
Secretary of Veterans Affairs
810 Vermont Ave., NW
Washington, D.C. 20420

Dear Secretary Wilkie:

I recently discussed the link between post-traumatic stress disorder (PTSD) and dementia with a group of veterans in my district. They expressed concern that the Department of Veterans Affairs (VA) does not recognize dementia developed later in life as being a secondary condition of service-connected PTSD.

VA regulations (38 CFR 3.310) state that a “disability which is proximately due to or the result of service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition.” The regulations also presume five conditions, including three types of dementias, as being the proximate result of service-connected traumatic brain injury (TBI).

There is good reason to believe that PTSD may be linked with later development of dementia. A Department of Defense-funded study published in the June 2010 issue of Archives of General Psychiatry found that veterans with PTSD were almost twice as likely to develop Alzheimer’s disease as veterans without PTSD.[[1]] Another study published in the September 2010 issue of Journal of the American Geriatrics Society found similar results.[[2]] Additionally, a study published in the July 2017 issue of The EMBO Journal found experimental evidence that the link between PTSD and Alzheimer’s and dementia may be causal.[[3]]

Our nation owes an immeasurable amount of gratitude to members of our armed services and their families for the sacrifices they’ve made to protect our country’s values and principles. The best way to honor this sacrifice is by ensuring that our veterans receive the benefits and services they have earned and deserve.

As a Congressman representing much of San Antonio – Military City, USA – I am committed to ensuring that the more than 60,000 veterans who live in my district receive disability rates that accurately reflect both the injuries sustained during their service and secondary conditions developed later in life as a result. Therefore, I am seeking information on the following questions in relation to the VA’s recognition of links between PTSD and Alzheimer’s and dementia:

  • Has the VA recognized Alzheimer’s or dementia as secondary conditions of PTSD under 38 CFR 3.310 in any cases?
  • If so, in approximately how many cases has this link been recognized?
  • Has the VA conducted any studies on the potential linkage of PTSD and dementia and Alzheimer’s?
  • What training, if any, does the Veteran Benefits Administration (VBA) conduct for their employees on the link between PTSD and dementia and Alzheimer’s?

Thank you for your attention to this important issue.

Respectfully,

Joaquin Castro
Member of Congress

 

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[[1]] “Posttraumatic Stress Disorder and Risk of Dementia Among US Veterans.” Arch Gen Psychiatry. 2010. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210821

[[2]] “Greater Prevalence and Incidence of Dementia in Older Veterans with Posttraumatic Stress Disorder.” Journal of American Geriatrics Society. 2010. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415.2010.02977.x

[[3]] “Formin 2 links neuropsychiatric phenotypes at young age to an increased risk for dementia.” The EMBO Journal. 2017. http://emboj.embopress.org/content/early/2017/07/31/embj.201796821