A-107 Historyt of Remote Mild TBI Predicts Poor Health-Related Quality of Life Outcomes in Military Veterans

Abstract

Abstract Objective We examined health-related quality of life (QOL) in military Veterans with and without a history of mild traumatic brain injury (mTBI). Additionally, we investigated how mTBI injury characteristics modify health-related QOL. Method Veterans with a history of remote mTBI (n = 81) and military controls (MCs) without a history of mTBI (n = 62) completed self-report questionnaires measuring combat exposure, posttraumatic stress disorder (PTSD) and neurobehavioral symptoms, and health-related QOL. Primary outcomes included the eight subscales of the 36-Item Short-Form Survey (SF-36). Results ANCOVAs adjusting for combat exposure and PTSD symptoms found that the mTBI group demonstrated significantly more health-related QOL symptoms when compared to MCs across the following SF-36 subscales: General Health, Vitality, Bodily Pain, Physical Role Functioning, and Social Functioning (p = .001–.045, ηp2 = 0.03–0.07). Within the mTBI sample, repetitive mTBI, combat exposure, and PTSD and neurobehavioral symptoms collectively significantly predicted all five QOL subscales (all p’s < .001), accounting for roughly 33–53% of the total variance. Greater neurobehavioral symptoms were associated with lower Physical Role Functioning, Vitality, and Social Functioning scores; repetitive TBI was associated with higher Bodily Pain scores; greater PTSD symptoms were associated with lower Social Functioning scores; and greater combat exposure was associated with lower General Health scores. Conclusions Results suggest that, over and above PTSD and combat exposure, mTBI status independently contributes to health-related QOL. Moreover, specific dimensions of health-related QOL are influenced by different factors, with affective and vestibular-related neurobehavioral symptoms showing the strongest negative associations with health-related QOL. Findings highlight the need for comprehensive assessment and multimodal treatment within this vulnerable population.