Skip main navigation

Military Health System

Clear Your Browser Cache

This website has recently undergone changes. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.

More Inclusive Research Key to Understanding Prevalence of Dementia

Image of Animated image of brain. Research shows women may be at greater risk of developing dementia, including Alzheimer’s disease. In the military, this affects the female veteran population. Photo credit: U.S. Army Master Sgt. Timothy Lawn

Rather than being considered a specific disease, the National Institute on Aging defines dementia as a general term for a range of neurological conditions that affect the brain and get worse over time. It includes losing the ability to remember, think, and reason to levels that affect your everyday life and activities.

Though dementia affects over six million people in the United States, the Centers for Disease Control and Prevention states that women are at higher risk—nearly twice that of men—of developing Alzheimer’s disease, one of several progressive cognitive disorders common in older adults.

According to the NIA, there are several types of dementia:

  • Alzheimer's disease: Caused by changes in the brain, including abnormal buildups of proteins, it's the most common dementia diagnosis among older adults. According to the National Plan to Address Alzheimer's Disease , "It is a major public health issue and will increasingly affect the health and well-being of the population."
  • Frontotemporal dementia: Rare and tends to occur in people younger than 60, who have abnormal amounts or forms of certain proteins.
  • Lewy body dementia: Caused by abnormal deposits of a protein called Lewy bodies.
  • Vascular dementia: Caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain.
  • Mixed dementia: A combination of two or more types of dementia

Risk Factors for the Military

Military service members "may be at greater risk for developing dementia due to a higher prevalence of traumatic brain injury, posttraumatic stress disorder, and depression," according to a 2019 National Institutes of Health study the Department of Defense supported.

The study included a cohort of female veterans aged 55 and older and concluded that women with TBI, depression, and post-traumatic stress disorder had an increased risk of developing dementia than women without those diagnoses. It also found that female veterans with multiple risk factors had more than twice the risk of developing the condition than those who did not have those conditions.

This and other studies like it help explain why "veterans are at increased risk of dementia due to some risk factors associated with being in the military," said U.S. Air Force Maj. Elizabeth Trahan, a clinical neuropsychologist and mental health flight commander with the 96th Medical Group at Eglin Air Force Base, in Florida.

Deployed service members "probably aren't sleeping as well," Trahan continued. "And they may be at increased risk to trauma exposure if they're in a combat zone or if they're exposed to a lot of explosives."

"But those risks don't only happen in a deployed environment," said Trahan.

"We have a lot of service members who have trauma and TBI from training exercises or non military related activities, but deployments make service members more prone to be exposed to those conditions which could potentially increase their risk," she said.

Although there were more than 458,000 reported traumatic brain injuries in the DOD between 2000-2022, "most TBIs occur in noncombat settings," according to the Defense Health Agency's Traumatic Brain Injury Center of Excellence.

"For example, service members can sustain a TBI during day-to-day activities, such as while playing sports or participating in recreational events, military training, and military deployment," according to the TBICoE.

Reasons Behind the Inequity

There are several reasons for the inequity, said Trahan.

"For a long time, the argument was that women live longer than men," she said. "So, of course, we were going to have higher numbers of women with dementia simply because they were outliving men."

But experts know now that that's not the only reason and that doesn't solely explain why that happens, she added.

"It's a complex issue that involves hormones, inflammatory markers, different risk factors that women might be prone to that men might not, but also probably to some stereotypes and biases against women that have resulted in less access to education and health care in some cases."

Genetics and reproduction could also play a role, said U.S. Air Force Col. (Dr.) Mary Anne Kiel, a pediatrician and chair of the Defense Health Agency's Primary Care Clinical Community.

Yet, for both men and women, there are ways to prevent dementia.

"Research shows that up to 60% of dementia may be preventable with a healthier lifestyle", said Kiel. "Other leading research in this area estimates that optimizing one's lifestyle may reduce the risk of dementia by as much as 90%."

Female military personnel Female veterans with diagnoses of post-traumatic stress disorder, traumatic brain injury, and depression may be at increased risk of developing dementia than women without those diagnoses. Photo credit: U.S. Army Spc. Joseph Black

Impacts on Readiness

“It’s key to focus on preventative efforts, preventative medicine, those self-help things that people can do to try to get ahead of it before it becomes an issue, impacts readiness, and so that it has less of an impact on the strain on our health care resources available to veterans and military members,” Trahan said.

“Recommended preventative strategies include a healthy diet, exercise, routine health care, those kinds of things,” she added, emphasizing they’re the same for men and women.

“Honestly, if it's good for your body, it's good for your brain,” she said.

For Kiel, a healthy diet implies changing to a predominantly whole plant foods diet more vegetables, fruits, whole grains, legumes, nuts, and seeds, while minimizing processed foods and eliminating red and processed meats.

She agreed that preventive strategies, “can not only improve our individual readiness but also significantly protect us from negative effects of stressors—such as injury and illness—and aid in recovery as well as minimize the risk of developing future chronic diseases, including Alzheimer’s disease.”

Promoting Brain Health

Trahan explained improving your sleep is key to brain health.

She noted additional research shows “that people who have prolonged sleep problems are also at higher risk for developing dementia.”

Kiel explained that during sleep, “our brains use that time to clean up the trash that has accumulated while we’re awake. If we don’t get adequate restful sleep, those harmful toxins remain and accumulate over time in the brain. The buildup of toxic proteins has been linked to Alzheimer’s and dementia.”

Since “sleep is a challenge in the military, just due to the nature of our job and deployments, practicing healthy sleep habits and trying to get an adequate amount of sleep is something else that people can do,” to promote brain health, said Trahan.

She added it’s important to take on activities that activate the brain. “Make sure you do things that are cognitively stimulating,” she said, like staying engaged in social or academic activities with a goal of learning something new.

“Constantly doing something that keeps your brain active helps keep your brain young,” she said.

Some of these activities can include crossword puzzles, playing a musical instrument, or learning a new language to keep your brain active, challenged, and engaged. However, if you’re already good at those things, it’s time to challenge yourself to do something new, say experts.

More Diverse and Inclusive Research

“There are lots of different correlations to the development of dementia,” said Trahan. “We need to do more research; we need to learn more about those. And as part of that research, it’s really important to make sure we are including women.”

She said that some of the limitations and the reasons there are so many unknowns is because the research is not including diverse populations.

In the case of women, “we just don't know enough about why women are at increased risk,” yet much of the available research shows “some pretty big discrepancies in terms of the sample population, or that the study population is conducted primarily on men,” Trahan said.

As such, recruiting women to be a part of the research is especially important.

DOD Efforts

The DOD has a variety of resources on TBIs, including fact sheets, podcasts, and more.

In June 2022, DOD put in place the Warfighter Brain Health Initiative, a joint effort between operational and medical communities to better address the brain health needs of service members, their families, line leaders, commanders, and their communities at large.

“The strategy and action plan addresses brain exposures, to include blast exposures, TBl, and long term or late effects of TBl, with the goal of optimizing brain health and countering TBI,” said the memorandum Deputy Secretary of Defense Kathleen Hicks and Vice Chairman of the Joint Chiefs of Staff Christopher W. Grady signed to implement the initiative.

“Our goal must be to ensure our warfighters are performing at optimized capacity and if exposed or injured by a known or emerging hazard, we return our warfighters to full health to include their brain health to maximize each individual's quality of life,” they said in the strategy and action plan.

The initiative aims to:

  • Optimize cognitive and physical performance
  • Identify, monitor, and mitigate brain exposures
  • Prevent, recognize, and minimize the effects of TBI
  • Reduce or eliminate long-term and late effects
  • Advance warfighter brain health science

It also emphasizes good sleep as a critical health element.

“We are emphasizing sleep quite a bit in the Comprehensive Strategy and Action Plan for Warfighter Brain Health,” said Dr. David Brody, chief science and innovation officer at the Center for Neuroscience and Regenerative Medicine of the Uniformed Services University of the Health Sciences, in Bethesda, Maryland.

"Across the DOD, including USU, Walter Reed Army Institute of Research, and many other sites, we are doing many research studies to learn how to better treat sleep problems that occur in the military. Good, quality sleep is key," he said.

For more information on brain health, memory loss, and other markers of dementia, talk to your health care provider.

You also may be interested in...

Article Around MHS
Oct 2, 2023

Suicide Care Prevention and Research Initiative at the Uniformed Services University Builds Interventions to Reduce Military Suicide

The Suicide Care, Prevention, and Research Initiative provides support for chaplains, spouses, military leadership, and other gatekeepers of service members. The program builds, scientifically tests, and implements suicide prevention programs by incorporating knowledge gained from service members who have died by suicide as well as those with suicidal thoughts and/or behaviors. (U.S. Army photo by Michele Wiencek)

While numerous programs work to develop strategies to lessen the national suicide rate, a standout in the military community is the Suicide Care, Prevention, and Research Initiative at the Uniformed Services University.

Article Around MHS
Sep 15, 2023

Preventing Suicide Through Social Connectedness

Suicide is a significant public health issue that impacts individuals, families, communities and society at large. Many risk and protective factors play an integral role in the prevention of suicide, including social connectedness, which occurs when people or groups are engaged in relationships that create a sense of belonging and being cared for, valued and supported. (Defense Centers for Public Health-Aberdeen graphic illustration by Jason Embrey)

Suicide is a significant public health issue that impacts individuals, families, communities and society at large. The issue is also tied to what the U.S. Surgeon General, Dr. Vevek Murthy, called an “Epidemic of Loneliness and Isolation” in a May health advisory that calls for a National Strategy to Advance Social Connection.

Article Around MHS
Sep 11, 2023

A Profile in Courage: Former Marine Shares Her Breast Cancer Survivor Story

Stephanie Bowens, a former Marine, cancer survivor, and nursing administrator, contemplates her day at Walter Reed Military Medical Center, preparing for an upcoming breast reconstruction surgery. (Photo: Ricardo Reyes-Guevara, Walter Reed Military Medical Center)

Former Marine Stephanie Bowens stands quietly in the nerve center of Walter Reed Military Medical Center’s nurse administration office, gathering her thoughts before coordinating schedules, arranging meetings, and fostering camaraderie among her talented teammates. It’s the perfect position for a creative, energetic, and organized leader who ...

Article Around MHS
Sep 7, 2023

Dog Jog for Life: Unlocking the Power of Pets in Suicide Prevention

For Suicide Prevention Month, emphasize the importance of escorting individuals in need to the best available help, ensuring they receive the assistance they require. However, in our efforts to support human lives, we sometimes overlook a remarkable source of solace and strength—our pets.  (Photo By Russell Jordan)

A U.S. Army public affairs officer highlights the importance of dogs in mental health while promoting "Dog Jog for Life," an event that embodies the spirit of suicide prevention, intervention, and postvention at U.S. Army Garrison Rheinland-Pfalz. “Our dogs often understand our moods better than we do ourselves. They offer us empathy, share in our ...

Article Around MHS
Aug 17, 2023

Breastfeeding Awareness Month Health Fair Big Hit for Bayne-Jones Army Community Hospital, Fort Johnson

Jesse Olson, aviation safety officer and certified child passenger safety technician at the Joint Readiness Training Center and Fort Johnson, Louisiana discussed the proper installation of and conducted a safety seat inspection for Nahomi Ortiz during the Breastfeeding Awareness Month family health fair August 5, at Bayne-Jones Army Community Hospital.  (Photo: Jean Graves)

Bayne-Jones Army Community Hospital hosted a Breastfeeding Awareness Month family health fair on Aug. 5, 2023, at the Joint Readiness Training Center and Fort Johnson, Louisiana. The event, coordinated by the BJACH Labor, Delivery and Post Partum ward and the OB/GYN clinic, was designed to give new and expectant parents an opportunity to learn about ...

Article Around MHS
Jul 25, 2023

Defense Public Health Experts Investigate If Minority Group Service Members are More Likely to Experience Behavioral Health Problems

A recent Department of Defense study found American Indian and Alaska Native U.S. Army Soldiers had higher rates of suicidal ideation than white soldiers. The DOD is investigating behavioral health disparities among minority groups in the military to see how they might mirror similar disparities in the civilian population. (Graphic illustration: Steven Basso, Defense Centers for Public Health-Aberdeen)

U.S. public health agencies such as the National Institute of Mental Health have recognized that certain minority groups appear to experience greater risk for certain behavioral health disorders. The higher rates of adverse health problems in minority groups are often referred to as “disparities.”

Skip subpage navigation
Refine your search
Last Updated: December 01, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery