Changes in Health Status in the Ft. Devens Gulf War Veterans Cohort: 1997-2017

Gulf War veterans (GWVs) were exposed to numerous neurotoxicants during deployment. Upon returning home, many reported a multitude of symptoms including fatigue, pain, gastrointestinal and respiratory issues, and neurological, cognitive, and mood complaints, collectively termed “Gulf War Illness (GWI).” Now, nearly 30 years post-war, many GWVs continue to suffer from these symptoms, in addition to health concerns associated with normal aging. While most research on GWVs has been cross-sectional, it is important to evaluate the progression and onset of new GWI symptoms longitudinally. The current study investigated the health of GWVs 25+ years after the war by resurveying the Ft. Devens Cohort and comparing their current health to their health reported 15 to 20 years earlier. The sample consists of 317 GWVs (~54 years old at the latest survey, 38 women) who responded to both surveys (1997-1998 and 2013-2017). Multivariable regression analyses were used to assess changes in GWI symptomatology and prevalence of medical conditions. The rates of 12 of 25 health symptoms increased significantly from the prior 1997-1998 survey. Anxiety, numbness in extremities, depressed mood, and joint pain had the greatest increase in endorsement. The rates of 7 of 16 medical conditions increased significantly from the prior 1997-1998 survey. High blood pressure, diabetes, and cancer had the greatest increase in prevalence. In summary, this study demonstrates that both symptoms and physician-diagnosed medical conditions associated with GW deployment/exposure increased in prevalence. For GWVs, focus by providers on the treatment of cognitive and mental health issues as well as cardiovascular and cerebrovascular risk factors is warranted. Targeting symptom alleviation would help improve the quality of life in these veterans until treatments addressing the entire illness become available.

[1]  T. Heeren,et al.  Longitudinal Assessment of Health Symptoms in Relation to Neurotoxicant Exposures in 1991 Gulf War Veterans: The Ft. Devens Cohort. , 2020, Journal of occupational and environmental medicine.

[2]  S. Coughlin,et al.  Rates of Chronic Medical Conditions in 1991 Gulf War Veterans Compared to the General Population , 2019, International journal of environmental research and public health.

[3]  Rudolph P. Rull,et al.  Health Status of Gulf War and Era Veterans Serving in the US Military in 2000 , 2018, Journal of occupational and environmental medicine.

[4]  O. Osinubi,et al.  Report of Autonomic Symptoms in a Clinical Sample of Veterans with Gulf War Illness. , 2018, Military medicine.

[5]  S. Proctor,et al.  Multiple Mild Traumatic Brain Injuries Are Associated with Increased Rates of Health Symptoms and Gulf War Illness in a Cohort of 1990–1991 Gulf War Veterans , 2017, Brain sciences.

[6]  S. Proctor,et al.  Self-Reported Traumatic Brain Injury, Health and Rate of Chronic Multisymptom Illness in Veterans From the 1990-1991 Gulf War , 2016, The Journal of head trauma rehabilitation.

[7]  M. Sim,et al.  New Onset of Chronic Diseases and Changes in Lifestyle Risk Factors Among Gulf War Veterans: A Longitudinal Comparison of High and Low Symptom Reporters , 2016, Journal of occupational and environmental medicine.

[8]  D. Cory-Slechta,et al.  Gulf War and Health: Volume 10: Update of Health Effects of Serving in the Gulf War, 2016 , 2016 .

[9]  D. Cory-Slechta,et al.  COMMITTEE ON GULF WAR AND HEALTH, VOLUME 10: UPDATE OF HEALTH EFFECTS OF SERVING IN THE GULF WAR , 2016 .

[10]  R. Bossarte,et al.  Physical and Mental Health Status of Gulf War and Gulf Era Veterans: Results From a Large Population-Based Epidemiological Study , 2016, Journal of occupational and environmental medicine.

[11]  M. Sim,et al.  Increased symptom reporting persists in 1990-1991 Gulf War veterans 20 years post deployment. , 2015, American journal of industrial medicine.

[12]  T. Maddox,et al.  Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. , 2015, World journal of diabetes.

[13]  Ronald R. Bach Gulf War Illness Inflammation Reduction Trial , 2015 .

[14]  Han K. Kang,et al.  Longitudinal health study of US 1991 Gulf War veterans: changes in health status at 10-year follow-up. , 2011, American journal of epidemiology.

[15]  C. DeCarli,et al.  Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline , 2011, Alzheimer's & Dementia.

[16]  G. Giannakoulas,et al.  Diabetes mellitus and cerebrovascular disease: which are the actual data? , 2009, Journal of diabetes and its complications.

[17]  B. Golomb,et al.  Acetylcholinesterase inhibitors and Gulf War illnesses , 2008, Proceedings of the National Academy of Sciences.

[18]  Deborah A Yurgelun-Todd,et al.  Quantitative magnetic resonance brain imaging in US army veterans of the 1991 Gulf War potentially exposed to sarin and cyclosarin. , 2007, Neurotoxicology.

[19]  Roberta F. White,et al.  Effects of sarin and cyclosarin exposure during the 1991 Gulf War on neurobehavioral functioning in US army veterans. , 2006, Neurotoxicology.

[20]  Darin J Erickson,et al.  Risk Factors for Multisymptom Illness in US Army Veterans of the Gulf War , 2002, Journal of occupational and environmental medicine.

[21]  K. Lindem,et al.  Neuropsychological function in Gulf War veterans: relationships to self-reported toxicant exposures. , 2001, American journal of industrial medicine.

[22]  L. Steele,et al.  Prevalence and patterns of Gulf War illness in Kansas veterans: association of symptoms with characteristics of person, place, and time of military service. , 2000, American journal of epidemiology.

[23]  J. Turner,et al.  Emotional dimensions of chronic disease. , 2000, The Western journal of medicine.

[24]  A. Dyer,et al.  Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women. , 1999, JAMA.

[25]  P. Whelton,et al.  Elevated systolic blood pressure and risk of cardiovascular and renal disease: overview of evidence from observational epidemiologic studies and randomized controlled trials. , 1999, American heart journal.

[26]  D Ozonoff,et al.  Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress. , 1998, International journal of epidemiology.

[27]  W. Reeves,et al.  Chronic multisymptom illness affecting Air Force veterans of the Gulf War. , 1998, JAMA.

[28]  R. Ursano,et al.  The Impact of a Military Air Disaster on The Health of Assistance Workers: A Prospective Study , 1989, The Journal of nervous and mental disease.

[29]  Rudolph P. Rull,et al.  Prevalence of Chronic Multisymptom Illness/Gulf War Illness Over Time Among Millennium Cohort Participants, 2001-2016. , 2019, Journal of occupational and environmental medicine.

[30]  M. Sim,et al.  Major depression and depressive symptoms in Australian Gulf War veterans 20 years after the Gulf War. , 2016, Journal of affective disorders.