9/11 responders may be at higher risk for dementia, researchers find

One study led by Stony Brook University researchers found that the brain "age" of some World Trade Center responders is 10 years older on average than the general population


By Laura French

STONEY BROOK, N.Y. — Two recent studies have found that 9/11 first responders may be at a heightened risk for developing dementia. 

The studies, led by Stony Brook University researchers, were presented at the virtual Alzheimer's Association International Conference on Tuesday.

These brain images are a compilation of MRI results from 9/11 responders. The images show gray matter atrophy on the brain, with yellow and red areas revealing statistically significant atrophy compared to the normal population. Red areas show worse atrophy than yellow. (Photo/Stony Brook University)
These brain images are a compilation of MRI results from 9/11 responders. The images show gray matter atrophy on the brain, with yellow and red areas revealing statistically significant atrophy compared to the normal population. Red areas show worse atrophy than yellow. (Photo/Stony Brook University)

"The environmental exposures and psychological pressures experienced by responders during 9/11 and its aftermath have had an insidious effect on their health and well-being. Now nearly 20 years post-911, clinicians who care for these individuals are seeing more patients who are showing signs of cognitive disorders and possible dementia," said Benjamin Luft, MD, the director of the Stoney Brook World Trade Center Health and Wellness Program. "Findings from our new studies provide data for the first time that support the idea that this population of patients who have cognitive impairment not only have psychological problems such as PTSD but may be at high-risk for neurodegenerative disorders, a possibility that needs immediate and continued investigation."  

One study, published in the Alzheimer's Association journal Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, found that many World Trade Center responders with cognitive impairment (CI) have a brain "age" that is about 10 years older on average than the general population, according to a Stoney Brook University news release

Stony Brook researchers, in collaboration with a team from the Icahn School of Medicine at Mount Sinai, used MRI imaging to assess the brain matter of 9/11 responders between the ages of 45 and 65 with and without symptoms of CI and found that in those with CI symptoms, many showed areas of atrophy in the brain cortex. Researchers noted that this atrophy is rare in those of the same age group in the general population. 

The study also found that responders both with and without CI symptoms showed significant reductions in cortical thickness in seven regions in or near the temporal lobe compared with published data on the general population. 

Lead author Sean Clouston, Ph.D., an associate professor of family population and preventative medicine at the Stony Brook Program in Public Health, said the level of cortical thickness reduction in many responders was similar to that of dementia patients and is "a possible indicator of early-stage dementia with possible early-onset dementia likely to occur for a portion of these individuals at midlife." 

Clouston added that further research would be needed to determine whether these changes would progress over time, and what the specific cause was of brain atrophy and cortical thickness reductions in WTC responders. 

A second study, published in the journal Translational Psychiatry, analyzed 276 proteins in the blood of 181 WTC responders with PTSD and mild CI, and found that some responders showed signs of proteinopathy, or problematic changes in the proteins in their body, consistent with Alzheimer's and related diseases.

The proteins studied are instrumental to a range of processes involving neurological, immunological, cardiovascular, inflammatory, developmental, metabolic and cellular regulation functions. 

"We believe that neuro-inflammation is a possible mechanism in which responders with PTSD appear to be at a higher risk of developing mild cognitive impairment," said Luft, who was the senior author of the protein study. "We hope our unique analysis of proteins associated with cognitive-impairment-related diseases in this population is an additional way to identify their risk based on changes in their body likely due from their exposures."

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