Cognitive Impairment in Firefighters and Emergency Medical Services Workers after Severe WTC Exposures
Bibliographic record
Abstract
Abstract Background Members of the Fire Department of New York (FDNY) who responded to the World Trade Center (WTC) attacks that occurred on 9/11/2001 were exposed to severe trauma. The present study screened for cognitive impairment in a prospective cohort study of FDNY fire fighters and emergency personnel who reside in the greater NYC metropolitan area. Method A large sample (n = 338) of FDNY personnel who were exposed to the WTC attacks were recruited to complete a large battery of neuropsychiatric and psychological tests. The Montreal Cognitive Assessment (MoCA) was used to screen for mild cognitive impairment (MCI) and probable dementia. Neuropsychiatric, psychological, and physical deficits were further characterized by the Short Physical Performance Battery (SPPB), Hopkins Verbal Learning Task (HVLT‐R), Boston Naming Task (BNT), Wide Range Achievement Test (WRAT‐4), Trail‐Making Task (TMT), Symbol Digit Modalities Test (SDMT), Controlled Oral Word Association (COWA), Patient Health Questionnaire (PHQ‐9), and the Cognitive Function Instrument (CFI). Diagnoses of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) were made using the Structural Clinical Interview for DSM‐5. Result Compared to the general population, prevalence of MCI (22.92%, CI.95 = [18.42%, 27.63%]) and probable dementia (4.14%, CI.95 = [2.28%, 6.85%]) were precipitously high. Compared to unimpaired firefighters, those with MCI and probable dementia exhibited statistically significant deficits (p‐values < .05) on the HVLT‐R, BNT, WRAT‐4, TMT, SDMT, and COWA, while differences on the SPPB, PHQ‐9, and CFI were not statistically significant (p‐values > .05). Prevalence of current PTSD (18.05%, CI.95 = [14.10, 22.57] and MDD (6.51%, CI.95 = [4.12%, 9.69%] were high and moderate, respectively, but not significantly associated with MCI or probable dementia (p‐values > .05). Conclusion There is a high prevalence of MCI and probable dementia among member of the FDNY who responded to the WTC attacks. The present study further highlights the role of extreme physical exposes in the pathogenesis of cognitive impairment and dementia. This group is a high priority for public health efforts and clinicians need to anticipate MCI and dementia in treatment planning.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".