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CHARACTERIZING DEFICIT ACCUMULATION AMONG GULF WAR ERA VETERANS

S.E. Petry, A.D. Thompson, Jr., E.R. Hauser, S.M. Lynch, S.H. Boyle, J. Upchurch, A. Press, K.J. Sims, C.D. Williams, E.J. Gifford

J Frailty Aging 2024;13(3)300-306

BACKGROUND: Veterans of the first Gulf War (1990-1991) are reaching middle and older adulthood in differing degrees of health and biological age. Many Gulf War veterans report myriad negative symptoms classified as Gulf War illness (GWI), a chronic multi-symptom illness. OBJECTIVES: To describe and analyze deficit accumulation, among veterans with Severe GWI (SGWI+) and those without Severe GWI (SGWI-), to assess the association between a medically unexplained illness and aging. DESIGN: This study uses a retrospective cohort design with quasi-longitudinal data. SETTING: The recruitment sample included 10,042 Gulf War era veterans across all four US Census regions. PARTICIPANTS: The analytic sample included 1,054 participants of the GWECB for whom SGWI case status could be determined and who had valid responses for at least 90% of the deficits included in the deficit accumulation index. MEASUREMENTS: Chronic health conditions were retroactively reported, including year of diagnosis, enabling us to create a longitudinal measure of deficit accumulation. This deficit accumulation index (DAI) ranged from 0-1 for each respondent in each year between 1991-2013. We compare veterans with SGWI+ to those with SGWI- using the CDC case definition. RESULTS: Most veterans in our sample could expect to spend more years with moderate or substantial deficits than without deficits. SGWI+ was associated with spending more years with substantial deficits than those with SGWI-. Veterans in middle age (age 35-65) experienced more years with substantial deficits than younger veterans. Individuals with SGWI+ had 13 times the hazard of accumulating substantial deficits than those without. CONCLUSIONS: This study demonstrated that veterans with SGWI+, even those in midlife, experienced aging as measured by accumulating deficits. Practitioners should consider patients with multi-symptom illnesses as at risk of accelerated aging, tailoring treatments to address patients’ holistic needs.

CITATION:
S.E. Petry ; A.D. Thompson, Jr. ; E.R. Hauser ; S.M. Lynch ; S.H. Boyle ; J. Upchurch ; A. Press ; K.J. Sims ; C.D. Williams ; E.J. Gifford (2024): Characterizing Deficit Accumulation Among Gulf War Era Veterans. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2024.44

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