A-14 Exploring Interactions between Traumatic Brain Injury History and Gender on Medical Comorbidities in Military Veterans: An Epidemiological Analysis in the Million Veteran Program

Abstract

Abstract Objective: Epidemiological studies of gender differences in clinical outcomes following traumatic brain injury (TBI) are limited, especially among service members and Veterans. This study aimed to examine associations between TBI history and medical comorbidities and explore interactions with self-reported gender using a diverse sample of military Veterans. Method: Participants included 491,604 Veterans (48,646 TBI cases, 442,958 controls; 450,625 men, 40,979 women) who enrolled in the VA’s Million Veteran Program. Outcomes of interest included the following medical condition comorbidities from the MVP Baseline Survey: (1) psychiatric, (2) neurological, (3) cardiovascular, (4) skeletomuscular, and (5) other conditions. We explored the interaction of TBI history and gender on medical comorbidities using adjusted logistic regression models. Results: Veterans with a history of TBI had significantly higher rates of medical comorbidities compared to controls, with the strongest associations observed across psychiatric (adjusted OR’s = 2.10–3.61) and neurological (adjusted OR’s = 1.57–6.08) conditions. Significant interactions of TBI history and gender were observed across the majority of psychiatric and neurological comorbidities. Specifically, female Veterans with TBI history had significantly higher rates of attention-deficit/hyperactivity disorder, anxiety, bipolar disorder, major depressive disorder, personality disorder, headache/migraine, epilepsy, and multiple sclerosis, while male Veterans with TBI history had significantly higher rates of schizophrenia, memory loss or impairment, and spinal cord injury. Conclusions: Results indicate that females and males experience differential clinical outcomes following TBI, particularly for rates of psychiatric and neurological comorbidities. Findings highlight the need for more research on gender differences in the context of TBI to better improve the clinical care offered to this population.