During the 19 years of the Vietnam War, the United States waged a roughly decade-long “herbicidal warfare” program — a campaign called Operation Ranch Hand. Agent Orange was the most commonly used “tactical-use” herbicide and defoliant. About half a century later, the powerful chemical still casts a long shadow: New research suggests that veterans exposed to Agent Orange are at heightened risk of developing dementia.
In a massive aerial campaign during the Vietnam War, the United States Air Force sprayed nearly 19 million gallons of herbicides in South Vietnam to strip the enemy of vegetation cover and food supplies. Roughly 11 million gallons of those chemicals were a highly toxic defoliant called Agent Orange. While it was banned by the U.S. in 1971, people exposed to it continue to suffer from related health effects today, ranging from heart disease and skin disorder to various types of cancers.
Now, a new study suggests that Agent Orange exposure could also elevate people’s likelihood of developing dementia. The research shows that U.S. veterans exposed to the herbicide are almost twice as likely to receive a dementia diagnosis than those without exposure.
“Vietnam veterans and family members should be aware that exposure to Agent Orange may increase risk of developing dementia and that symptoms of dementia may begin at a younger age,” Deborah Barnes, an author of the study and a researcher with the Department of Veterans Affairs and the University of California San Francisco, wrote in an email to Being Patient. “Consequently, Vietnam veterans should be adequately screened and treated for dementia in later life.”
In the recent study published in JAMA Neurology, Barnes and colleagues combed through electronic health records of more than 300,000 veterans who served between 1964 to 1975. About 12 percent of them were presumed to be exposed to Agent Orange.
Veterans with documented exposure to the chemical had roughly double the risk of developing dementia compared to those without. The association held up even after the researchers adjusted for demographics, medical conditions (i.e. diabetes, traumatic brain injury and Parkinson’s) and psychiatric conditions (i.e. depression, post-traumatic stress disorder and substance use disorder). Exposed veterans remained nearly twice as likely to be diagnosed with dementia, and they were about 15 months younger than unexposed veterans.
Dr. Paul Rosenberg of Johns Hopkins University told Medscape Medical News that the recent study demonstrates a “meaningful increase” in dementia risk associated with Agent Orange exposure, using robust methods and a large sample.
But, he said veterans exposed to Agent Orange may live less healthy lifestyles later in life, which would also put them at greater risk of developing dementia, though the variables could not be controlled for in the study.
“Although veterans can’t change their past, they can control
their future activities. It is possible that the increased risk of
dementia associated with Agent Orange exposure could be
offset by engaging in a healthy lifestyle.”
While it remains unclear why Agent Orange is associated with dementia, Barnes and colleagues suggested that the human carcinogen in Agent Orange known as dioxin could be a culprit. According to the researchers, the storage of dioxin in fat tissue may stimulate biological responses implicated in health conditions like diabetes and Parkinson’s, leading to a subsequent increase in dementia risk.
As fat tissue may release the toxin over time, Barnes told JAMA Neurology in an interview that dioxin could potentially cause toxic effects on the brain.
A 2018 report by the National Academies of Sciences, Engineering and Medicine, determined that Agent Orange could be associated with a host of health conditions, several of which — like high blood pressure (backed by strong evidence), diabetes and Parkinson’s disease (both are supported by limited evidence) — are also risk factors of dementia.
The two latter conditions, as well as other illnesses such as heart disease, skin disorder and various types of cancers, are under the Veteran’s Association’s list of illnesses “caused by exposure to Agent Orange,” which makes it easier for veterans to get disability compensation.
“When sound medical and scientific evidence shows that an illness is caused by Agent Orange exposure, we add it to our list of presumptive diseases,” the VA website reads. “If you’ve been diagnosed with one of these illnesses, you don’t need to prove that it started during—or got worse because of—your military service.” Last year, lawmakers added bladder cancer, hypothyroidism and Parkinson’s-like symptoms to the list, and some are now pushing to include high blood pressure as well.
However, Barnes said few studies so far have directly examined any direct link between Agent Orange and dementia. The authors of the 2018 report concluded there was not enough evidence to prove that the herbicide is tied with heightened risk of dementia, and the VA currently does not include dementia in its list of illnesses presumed to be caused by Agent Orange exposure.
Barnes noted that further research is needed not only to confirm the study’s findings, but to better understand the factors that influence dementia risk associated with Agent Orange, before it would be possible to reach any conclusions.
Providing quality data is critical to informing the VA’s policy as families are waiting for answers and looking for greater access to health care. One spouse of a veteran exposed to Agent Orange commented on a recent VA news release, noting that her loved one receives little benefits for the care services he needs for his dementia diagnosis.
Barnes also hopes to see more research into how veterans exposed to the chemical could reduce their heightened risk of developing dementia. After all, Barnes said that treatment for comorbidities and lifestyle interventions such as exercise, cognitively stimulating activities and social interaction have all been shown to potentially decrease dementia risk.
“Although veterans can’t change their past, they can control their future activities,” Barnes said. “It is possible that the increased risk of dementia associated with Agent Orange exposure could be offset by engaging in a healthy lifestyle.”
Meanwhile, Dr. Rosenberg urged veterans who were exposed to Agent Orange to be especially attuned to the early signs of cognitive impairment and to see their primary care clinicians if they notice any red flags.
Contact Nicholas Chan at email@example.com
10 thoughts on “Should the VA Add Dementia to Its List of Illnesses Caused by Agent Orange?”
My father has dementia served in Vietnam.. He was diagnosed at the age of 67
So sorry for you. My husband was an 82nd Air Borne Ranger in Viet Nam…has two Purple Hearts and the Bronze Star with Valor. He was covered in Agent Orange and every summer would get this horrible skin rash from it. Has dementia now. I firmly believe that it was and is caused by Agent Orange. My prayers are with you in this journey. It is a horrible disease.
So sorry for you.Im fighting now to get compensation for my dementia. I was in the mekong delta and every day we would pass thru areas where the agent orange had beensprayed ..you could tell because our eyes would start burning. Now they want medical proof that says the dioxin in agent orange causes dementia, They just keep throwing up roadblocks,
It saddens me to hear about the brave and honorable defenders of this great nation and how their lives have been stunted, or cut short, by various and untimely diseases caused by presumed exposure to agent orange. My husband was stationed at Takhli AFB during Vietnam. From what I’ve read, there are even sworn statements by veterans at the Thailand bases that agent orange was sprayed on the barracks and base perimeters. My husband has Aplastic Anemia, GERD, severe sleep Apnea and severe VERY early-onset Dementia (we noticed it since his 50’s). I too strongly believe that his conditions were caused by exposure to Agent Orange. And YES it is a horrible disease!!! Sending prayers to all of our suffering soldiers and to the families and caretakers of these honorable men.
Most definitely it should be added to the list. The VA has ignored so many things for way to long. This whole topic makes me so infuriated. My father has late stages Alzheimer’s and was exposed to Agent Orange. I am thoroughly disappointed with the VA and how they handle our vets!
My husband will be 77 Saturday and has Alzheimer’s which progressed rapidly. I have told every professional he has been examined by about this article hoping it may help another veteran. He spent 26 months in Vietnam. I encourage everyone who suspects their veteran may have dementia that was exposed to agent orange to be sure and report it to the VA
My husband was boots on the ground in vietnam, He has had bladder cancer severe neuropathy in both feet rare tumor with toe and metetorsal amputated vascular early onset dementia and nothing from VA they always have an excuse I PRAY for all our vets suffering from agent orange exposure
I was diagnose with dementia about a year ago. None of my family members had this disease. I served in the Navy in Viet Nam.
I suggest file for it, it will get denied but it’s on record. To my Brothers, Sisters, & Families. ALOHA from HAWAII
My husband has Vascular Dementia and was diagnosed about 5 years ago. He served 4 tours in Viet Nam and was exposed to Agent Orange. He has several health problems which are covered by the V A, but not the Dementia. Now they and their families are having to pay the price of it. My husband is struggling and I’m struggling watching him because of knowing the man he was and the man he is today. It is very, very hard and a very cruel disease. It’s heart breaking to the core! I don’t understand why the V A isn’t recognizing this as a disease caused by Agent Orange. It can not be prevented by your lifestyle. This is a brain disease. I plead with the V A to reverse their decision on Alzheimer/Dementia caused by Agent Orange. Thank You Very Much
I can’t understand why Dementia is not covered. My husband has heart disease, congestive heart failure, high blood pressure, Diabetes 2. All of these caused his Vascular Dementia which should not be difficult for anyone to understand. They state Agent Orange caused twice as many veterans to have Dementia. I don’t understand why there should be anymore studies on it. Even though my husband does receive 100% disability I still want it in his file that he has this illness.