Recent research from Stony Brook Medicine shows that early signs of dementia are becoming more frequent among first responders who served in the Sept. 11, 2001 terrorist attacks. A study published this past November in the Journal of Alzheimer’s Disease revealed that the presence of amyloid in the brain may be linked to World Trade Center exposure duration.

Stony Brook Medicine’s World Trade Center (WTC) Health and Wellness Program has provided healthcare for WTC-related conditions since the day of the attacks. Dr. Sean Clouston, a professor in the Department of Family, Population and Preventive Medicine in the Renaissance School of Medicine, Director of Public Health Research at Stony Brook University and lead author of the study specializes in neuroepidemiology has spent 12 years at Stony Brook, working alongside the WTC Health and Wellness Program to research neurological conditions related to aging.

“When we started doing this work, we were really focused on whether or not post traumatic stress disorder (PTSD) caused more rapid aging,” Clouston said. “But as that program expanded, we became aware of the fact that while those people were at higher risk, there was this huge body of people who didn’t have PTSD, but were also experiencing a lot of aging.”

As the program continued, Clouston and his team found that responders who were heavily exposed at WTC sites for a long period of time lacked proper personal protective equipment (PPE). The study monitored 35 WTC responders with different ranges of exposure status who underwent a series of school-like cognitive tests, physical functional measures and positron emission tomography magnetic resonance imaging (PET-MRI).

Stony Brook Medicine researchers specifically looked for the presence of amyloid in the brain scans. Amyloid is a protein commonly associated with Alzheimer’s disease, however it also acts as an immune protein. Rather than finding trace amounts of amyloid in the brain, the team found it concentrated in areas near the frontal aspects of the brain, specifically in the olfactory cortex which is the portion of the cerebral cortex focused on the sense of smell. 

“This matches up with one theory for how neurotoxic chemicals can affect the brain, which is that you inhale them through your nose and into your sinus cavities, and then they get dispersed through the olfactory nerve,” Clouston said.

Benjamin Luft, MD, co-author of the study and Director of the Stony Brook WTC Health and Wellness Program, said in a press release, “It is also important to emphasize that the presence of amyloid was associated with cognitive impairment in this cohort.”

Out of the 35 participants, the research team found that those with low grade amyloid near their nose were cognitively asymptomatic, whereas others who had traces of amyloid spread to other regions of the brain had symptoms associated with cognitive impairment, such as dementia.

Clouston’s research has reached nationwide audiences through news outlets, such as CBS News and The Washington Post, spreading awareness on the cognitive effects on first responders from the WTC attacks. The team plans on continuing to study the implications and long term effects of immune-related amyloidosis, specifically the possible connections between tauopathy, a condition where tau protein builds up and clumps together, damaging neurons.

“There’s a lot of questions about both the development, meaning and outcome [of amyloidosis] that are critically important,” Clouston said. “We also want to know more about what this disease means, where you’ve developed this thing, and now what? Just what does this mean for people? Those are the questions we don’t have strong answers to [yet].”