# Cognitive decline in U.S. military veterans: risk factors and clinical implications

**Authors:** Rob J. MacLennan, Benjamin A. Chapin, Laurence M. Solberg, David J. Clark

PMC · DOI: 10.3389/frdem.2026.1704367 · 2026-02-03

## TL;DR

Military veterans face higher risks for cognitive decline due to factors like diabetes and depression, requiring early screening and intervention.

## Contribution

The paper proposes an approach to managing cognitive decline risk factors specific to U.S. military veterans.

## Key findings

- Veterans have higher prevalence of cognitive decline risk factors compared to non-veterans.
- Unique military experiences contribute to increased risk for cognitive decline.
- Early screening and intervention are critical to reduce the burden of cognitive decline in veterans.

## Abstract

Military veterans have higher aggregate prevalence of risk factors for cognitive decline than non-veterans. This includes risk factors like diabetes, chronic pain, smoking, depression, and more. The disparity in prevalences is due in part to the unique experiences and exposures of their military service. Alzheimer's disease and other dementias are debilitating diseases with large financial and logistical burdens. These burdens are held by the patient, their family, friends, and caregivers, as well as healthcare professionals, and healthcare systems. Standardized screening for these risk factors may be helpful for understanding risk profiles that lead to cognitive decline. Additionally, screening must occur early to encourage early intervention and behavioral modifications and to reduce these burdens. This perspective presents the prevalence of risk factors for cognitive decline in the Veteran and non-veteran populations and proposes an approach to managing risk factors in Veterans.

## Linked entities

- **Diseases:** Alzheimer's disease (MONDO:0004975)

## Full-text entities

- **Diseases:** sleep apnea (MESH:D012891), Cognitive decline (MESH:D003072), Chronic pain (MESH:D059350), Depression (MESH:D003866), Hypercholesterolemia (MESH:D006937), obstructive sleep apnea (MESH:D020181), Type 2 diabetes (MESH:D003924), dementia (MESH:D003704), cardiovascular disease (MESH:D002318), insulin deficiency (MESH:D007333), death (MESH:D003643), Hypertension (MESH:D006973), PTSD (MESH:D013313), major depressive disorder (MESH:D003865), physical inactivity (MESH:C564765), Hearing impairment (MESH:D034381), social isolation (MESH:C565377), Burn pits (MESH:D002056), Obesity (MESH:D009765), smoking (MESH:D015208), Diabetes (MESH:D003920), insomnia (MESH:D007319), Drug Abuse (MESH:D019966), MCI (MESH:D060825), ADRD (MESH:D000544), OSA (MESH:C535586), TBI (MESH:D000070642), hyperglycemia (MESH:D006943), trauma (MESH:D014947), Physical (MESH:D059445), pain (MESH:D010146), Sleep disturbance (MESH:D012893)
- **Chemicals:** Alcohol (MESH:D000438), heavy metals (MESH:D019216), cholesterol (MESH:D002784), Agent Orange (MESH:D000075182)
- **Species:** Homo sapiens (human, species) [taxon 9606], Nicotiana tabacum (American tobacco, species) [taxon 4097]

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Source: https://tomesphere.com/paper/PMC12909232