Evidence map›Paper›PMID 39674910›Full record

ArticleAmerican journal of industrial medicine2025

Prevalence of Mild and Severe Cognitive Impairment in World Trade Center Exposed Fire Department of the City of New York (FDNY) and General Emergency Responders.

Frank D Mann, Alexandra K Mueller, Rachel Zeig-Owens, Jaeun Choi, David J Prezant, Melissa M Carr, Alicia M Fels, Christina M Hennington, Megan P Armstrong, Alissa Barber and 9 more

Abstract read
In one paragraph

Article in American journal of industrial medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Frank D MannDepartment of Family, Population, and Preventive Medicine, Program in Public Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.ORCID 0000-0002-5450-0620
Alexandra K MuellerFire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.ORCID 0000-0003-4028-6720
Rachel Zeig-OwensFire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.ORCID 0000-0002-8679-2306
Jaeun ChoiDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
David J PrezantFire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.
Melissa M CarrWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.ORCID 0000-0002-0870-6628
Alicia M FelsWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.ORCID 0009-0002-6229-2523
Christina M HenningtonWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Megan P ArmstrongWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Alissa BarberWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Ashley E FontanaWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Cassandra H KrollWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Kevin ChowWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Onix A MelendezWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Abigail J SmithWorld Trade Center Health Program, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Christopher ChristodoulouDepartment of Psychiatry & Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Benjamin J LuftDepartment of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Charles B HallDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
Sean A P CloustonDepartment of Family, Population, and Preventive Medicine, Program in Public Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.ORCID 0000-0002-6124-0329

Funding

Einstein-Montefiore Clinical and Translational Science Award HubUM1TR004400 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI Jessica Kahn, Mimi Y Kim · 2023 to 2026
$17.3M
A lifecourse approach to PTSD and cognitive aging: A cohort of 9/11 respondersR01AG049953 · NIA · STATE UNIVERSITY NEW YORK STONY BROOK · PI CLOUSTON, SEAN · 2015 to 2024
$11.0M
Trauma Exposure and Cognitive Impairment: Understanding Polygenic Liability and the Causative and Moderating Effects of Exposure, PTSD, and Psychiatric Comorbidity in WTC RespondersR21AG074705 · NIA · STATE UNIVERSITY NEW YORK STONY BROOK · PI MANN, FRANK D · 2021 to 2021
$354k
NCATS NIH HHS UM1 TR004400NIA NIH HHS R01 AG049953NIA NIH HHS R21 AG074705NIOSH CDC HHS U01 OH012258This research was supported by the National Institute for Occupational Safety and Health. This study was supported by the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health (1U01OH0122580100 and 75D301-22-C-15522) and the National Institute of Health/National Institute on Aging (R01 AG049953).
6 · The paper itself

Abstract

backgroundThe emergency personnel who responded to the World Trade Center (WTC) attacks endured severe occupational exposures, yet the prevalence of cognitive impairment remains unknown among WTC-exposed-FDNY-responders. The present study screened for mild and severe cognitive impairment in WTC-exposed FDNY responders using objective tests, compared prevalence rates to a cohort of non-FDNY WTC-exposed responders, and descriptively to meta-analytic estimates of MCI from global, community, and clinical populations.

methodsA sample of WTC-exposed-FDNY responders (n = 343) was recruited to complete an extensive battery of cognitive, psychological, and physical tests. The prevalences of domain-specific impairments were estimated based on the results of norm-referenced tests, and the Montreal Cognitive Assessment (MoCA), Jak/Bondi criteria, Petersen criteria, and the National Institute on Aging and Alzheimer's Association (NIA-AA) criteria were used to diagnose MCI. NIA-AA criteria were also used to diagnose severe cognitive impairment. Generalized linear models and propensity score matching were used to compare prevalence estimates of cognitive impairment to a large sample of WTC-exposed-non-FDNY responders from the General Responder Cohort (GRC; n = 7102) who completed the MoCA during a similar time frame.

resultAmong FDNY responders under 65 years, the unadjusted prevalence of MCI varied from 52.57% to 60.32% depending on the operational definition of MCI, apart from using a conservative cut-off applied to MoCA total scores (18 < MoCA < 23), which yielded a markedly lower crude prevalence (24.31%) compared to alternative criteria. Using propensity score matching, the prevalence of MCI was significantly higher among WTC-exposed FDNY responders, compared to WTC-exposed GRC responders (adjusted RR = 1.13 (CI 95% = 1.07-1.20, p < 0.001), and descriptively higher than meta-analytic estimates from different global, community, and clinical populations. Following NIA-AA diagnostic guidelines, 4.96% of WTC-exposed-FDNY-responders met the criteria for severe impairments (95% CI = 2.91-7.82), a prevalence that remained largely unchanged after excluding responders over the age of 65 years. DISCUSSION: There is a high prevalence of mild and severe cognitive impairment among WTC-responders, highlighting the putative role of occupational, environmental, and disaster-related exposures in the etiology of accelerated cognitive decline.

Indexed as

Cognitive DysfunctionEmergency RespondersOccupational DiseasesOccupational ExposureSeptember 11 Terrorist AttacksAdultAgedFemaleFirefightersHumansMaleMiddle AgedNeuropsychological TestsNew York CityPrevalencecognitive impairmentexecutive functionexposurememoryprevalence

Identifiers

PMID39674910
PMCPMC12175152

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.