19 Years Later, 9/11 First Responders Still Face Cognitive Issues


Nineteen years after the World Trade Center attacks, new research finds that PTSD and depression are related to cognitive issues in first responders. Those issues include difficulty recalling names and words, and greater reliance on written reminders.

Professor Laura Rabin (The Graduate Center, Brooklyn College) was an author on the paper, which appears in International Journal of Environmental Research and Public Health. The study was a collaboration with Albert Einstein College of Medicine and the New York City Fire Department.

The study looked at FDNY employees, both firefighters and emergency medical services workers, who worked at ground zero between Sept. 11 and 24 in 2001. The workers completed assessments for subjective cognitive and functional concerns, PTSD, and depression.

A previous study by Rabin and colleagues confirmed an association between exposure to the World Trade Center site, symptoms of PTSD and depression, and cognitive complaints. The new study organizes these factors by showing that the mental health symptoms act as the link between exposure and cognitive effects.

“In other words, mental health outcomes associated with greater World Trade Center exposure, rather than World Trade Center exposure alone, increase workers’ risk for subjective cognitive concerns,” the study says.

The study found that those who started working at the site on the morning of 9/11 had increased complaints compared to workers who arrived later.

These findings fit well with studies of veterans and certain other survivors of trauma that have shown PTSD and depressive symptoms are risk factors for mental dysfunction. Though forgetfulness can sometimes simply be a result of age, Rabin and colleagues saw that the cognitive effects were similar for both younger and older members of the study group.

Fortunately, symptoms of PTSD and depression are treatable, the authors say. Getting help for the workers’ mental health issues could in turn relieve the memory concerns.

The researchers cautioned that other issues related to working at the attack site, like sleep and pulmonary disorders, could also be factors in the cognitive problems. The researchers would need to do more analysis to say what exactly caused what.

That said, the link between cognitive concerns and working at ground zero is apparent even for people who don’t meet the criteria for being clinically diagnosed with either PTSD or depression. The results highlight that even having a few symptoms of mental health issues is a reason to seek treatment, the authors say.