April 24 (HealthDay News) -- Those serving in the armed forces tend to be in better health than the general population, but for veterans who experienced combat duty, that initial health advantage is erased.
In fact, aging combat veterans have a poorer quality of life than do non-combat veterans, according to a study that was to be presented Friday at the American Heart Association's 10th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke, in Washington, D.C.
"Combat veterans had poorer overall functional status and quality of life compared to men who served but didn't see combat," said study author Anna Johnson, an epidemiology researcher at the University of North Carolina at Chapel Hill.
"Combat has a lasting impact. It's not something that's stressful and then goes away. It looks like it has a lifelong impact on people's daily ability," Johnson said.
Although it's clear that combat is stressful and that such stress can have an impact on short-term health and well-being, the researchers said that the long-term impact on well-being and self-perceived health hasn't been well-studied.
To get an idea of the long-term impact of serving in combat, they reviewed data from 5,347 community-dwelling men between the ages of 52 and 75 who had participated in the fourth Atherosclerosis Risk in Communities (ARIC) study, which began between 1996 and 1998. Eighty percent of the men in this study were white, and 20 percent were black.
From this group, 2,042 were non-veterans, while 2,127 were classified as non-combat veterans. There were 1,178 combat veterans who had served in World War II, Korea or in Vietnam.
The researchers found that non-veterans were 37 percent more likely than non-combat veterans to report being in poor or fair health. This was true even after the data were adjusted for possible confounding factors, such as age, race, health insurance status, education, income and occupation.
Non-combat veterans also fared better than those who had seen combat. Veterans who served in conflicts were 31 percent more likely than non-combat veterans to report poor or fair health, even after the data was adjusted.
Non-combat veterans were also in better shape as far as functional status. Combat veterans and non-veterans were 75 percent more likely than non-combat veterans to have difficulty doing heavy work around the house, walking up and down stairs unassisted or to walk a half mile unassisted, according to the study.
"This is obviously concerning," said Dr. Joel Young, a psychiatrist at Beaumont Hospital in Royal Oak, Mich. "It appears that such a stressful life experience will have enduring consequences. Those who endured, those who witnessed hostility, seem to have compromised function later in life."
Although the study wasn't designed to assess the reason for these differences, Young said that people who are subjected to trauma can imprint those experiences and replay them, even years later, causing the same type of stress reaction, which causes the body to go into a hyperarousal state. And, he said, current research suggests that along with causing bursts of the stress hormone cortisol, such stress reactions may even cause actual degeneration in parts of the brain.
Whatever the mechanism behind these findings, Young said, "There's good evidence to suggest that people should get early help and intervention. Right now, the VA is very sensitive to the psychological consequences of combat, and the commitment to following up on the mental health needs of those returning from Iraq and Afghanistan seems to be more than it's ever been."
SOURCES: Anna Johnson, Ph.D., epidemiology researcher, University of North Carolina at Chapel Hill; Joel Young, M.D., psychiatrist, Beaumont Hospital, Royal Oak, Mich.; April 24, 2009, presentation, American Heart Association's 10th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke, Washington, D.C.