Recent data indicates that veterans face an elevated risk of developing Alzheimer’s disease and related dementia (ADRD) due to specific military exposures. Consequently, a new research protocol aims to investigate the utilization of HCBS for dementia care among post-9/11 veterans. These individuals often experience traumatic brain injuries (TBI) during service, which significantly accelerates cognitive decline. Therefore, understanding how these veterans access and prefer home- and community-based services is crucial for improving long-term health outcomes.

Improving Access to HCBS for Dementia Care

The study utilizes a mixed-methods observational design to quantify current service use. Furthermore, it seeks to identify the specific facilitators and barriers that veterans and their caregivers encounter daily. Researchers will analyze secondary data from the Department of Veterans Affairs and the Department of Defense. Additionally, the team will conduct interviews to gather rich descriptions of caregiver needs. By using a modified Delphi approach, the study will prioritize modifications to existing service frameworks.

Preliminary results show a substantial cohort of over 46,000 veterans, many of whom are at high risk for early-onset ADRD. On average, these veterans are 55 years old, highlighting the early nature of the cognitive risk. Because of this, the study specifically focuses on early-onset Alzheimer’s and frontotemporal dementia. Moreover, the project aims to establish a consensus on which service changes are most critical. Health system leaders will eventually receive these findings to guide future clinical policy decisions.

Frequently Asked Questions

Why do post-9/11 veterans have a higher dementia risk?

Veterans from the post-9/11 era are frequently exposed to blast-related traumatic brain injuries and chronic stress. Research suggests these factors can lead to accelerated biological aging and a significantly higher incidence of early-onset dementia compared to the general population.

What are common examples of home- and community-based services?

Common services include home health care, personal care assistance, adult day programs, and respite care. These interventions allow patients to live safely in their own homes while providing much-needed support for family caregivers.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or a professional relationship. Refer to the latest local and national guidelines for clinical practice.

References

Bouldin ED et al. Home- and Community-Based Service Use and Preferences Among Post-9/11 Veterans With or at High Risk of Alzheimer Disease and Related Dementia and Their Caregivers: Protocol for a Mixed Methods Observational Study. JMIR Res Protoc. 2026 Apr 29. doi: 10.2196/83629. PMID: 42054703.

Barnes DE, et al. Traumatic Brain Injury and Risk of Dementia in Contemporary Veterans. JAMA Neurology. 2018;75(8):1055-1061.