Temporal trends in the prevalence of psychiatric diagnoses among aging veterans in the U.S. Department of Veterans Affairs healthcare system: An analysis by sex, age, period, and cohort

Hind A Beydoun; May A Beydoun; Neil Nixdorff; Robert Wallace; Jack Tsai

doi:10.1016/j.psychres.2026.117291

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Temporal trends in the prevalence of psychiatric diagnoses among aging veterans in the U.S. Department of Veterans Affairs healthcare system: An analysis by sex, age, period, and cohort

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Temporal trends in the prevalence of psychiatric diagnoses among aging veterans in the U.S. Department of Veterans Affairs healthcare system: An analysis by sex, age, period, and cohort

Hind A Beydoun, May A Beydoun, Neil Nixdorff, Robert Wallace and Jack Tsai

Psychiatry research, Vol.364, 117291

10/2026

DOI: 10.1016/j.psychres.2026.117291

PMID: 42330865

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Abstract

Women and older adults represent rapidly growing segments of the US veteran population. Understanding sex-specific patterns in psychiatric diagnoses among aging veterans is essential for anticipating future healthcare service needs within the Department of Veterans Affairs (VA). The purpose of this retrospective study was to estimate prevalence and evaluate age-period-cohort trends in overall and broadly defined psychiatric disorders among women and men veterans aged ≥50 years. Using VA Corporate Data Warehouse data, 254,138 women veterans ≥50 years were 1:1 matched to 254,138 men veterans ≥50 years who used VA healthcare between 2000 and 2023. Twelve-month prevalence of overall psychiatric diagnoses and major diagnostic categories, including substance use disorders (SUDs) (alcohol, drug) and mental health disorders (mood, anxiety, and psychotic), were examined by sex across age, period, and cohort axes using descriptive and age-period-cohort interaction analyses. In the overall population, psychiatric diagnoses were identified in 9.0% of women and 10.6% of men veterans. Women had lower SUDs prevalence than men, with SUD rates declining with age in both sexes. Mental health disorders, particularly mood and anxiety disorders, increased during 2015-2023. Psychotic disorders increased with age but declined across calendar periods. Cohort effects were observed for several diagnostic categories, though less pronounced for alcohol use and mood disorders in both sexes and for psychotic disorders among women. In conclusion, psychiatric disorders are increasingly prevalent among more recent cohorts of aging US veterans, with distinct sex-specific age-period-cohort patterns, underscoring the need for tailored strategies for older women and men veterans.

Age effect

Psychiatric diagnoses

Veteran

Cohort effect

Sex

Period effect

Details

Title: Subtitle: Temporal trends in the prevalence of psychiatric diagnoses among aging veterans in the U.S. Department of Veterans Affairs healthcare system: An analysis by sex, age, period, and cohort
Creators: Hind A Beydoun - Health Services Research & Development
May A Beydoun - National Institute on Aging
Neil Nixdorff - Ann Arbor VA Medical Center
Robert Wallace - University of Iowa
Jack Tsai - The University of Texas Health Science Center at Houston
Resource Type: Journal article
Publication Details: Psychiatry research, Vol.364, 117291
DOI: 10.1016/j.psychres.2026.117291
PMID: 42330865
NLM abbreviation: Psychiatry Res
ISSN: 0165-1781
eISSN: 1872-7123
Publisher: Elsevier
Grant note: Department of Veterans Affairs National Institute on Aging Intramural Research Program
We thank the Department of Veterans Affairs and the Homeless Programs Office for their support of this study. May A. Beydoun's work on this project was supported by the National Institute on Aging Intramural Research Program.
Language: English
Electronic publication date: 06/17/2026
Date published: 10/2026
Academic Unit: Epidemiology; Injury Prevention Research Center
Record Identifier: 9985176656702771

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