Association Between Self-Reported Disability and Lifetime History of Traumatic Brain Injury With Loss of Consciousness Among Veterans and Nonveterans in North Carolina.
Kelly Sarmiento, Dana Waltzman, Jill Daugherty and 2 others
PMID 35125429WHAT IT FOUND
Veterans and nonveterans reporting a lifetime history of traumatic brain injury with loss of consciousness had higher rates of current disability.
Cognitive, independent living, and vision disabilities showed the strongest associations. This identifies a group needing careful functional assessment, but does not prove the injury caused the disability.
Key findings
01A lifetime history of TBI with loss of consciousness was associated with increased risk of having any disability (APR = 1.6) compared to those without such history.
02Among those with a TBI history, risks were elevated for specific disabilities: cognition (APR = 2.3), independent living (APR = 2.2), vision (APR = 1.9), self-care (APR = 1.9), hearing (APR = 1.7), and mobility (APR = 1.5).
03Veterans with a lifetime history of TBI had a higher risk of any disability (APR = 1.4) and hearing disability (APR = 2.0) compared to nonveterans with a similar history.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot determine if TBI caused the disability or if they are merely associated. Disability was self-reported and not verified as being related to the TBI event; many disabilities may have other causes. The survey only captured TBI with loss of consciousness, potentially missing those with milder TBI who did not lose consciousness. 24% of respondents did not answer the TBI question, and those who did were demographically different from those who did not, introducing potential bias. The study was limited to North Carolina, so results may not generalize to other states or populations. Institutionalized individuals and those with severe disabilities who could not complete a telephone survey were excluded, likely underestimating disability prevalence.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume that a patient's current disability was caused by their past TBI. The study shows an association, not causation, and explicitly states it was not possible to determine if the reported disabilities were related to the TBI event. Many disabilities may stem from other causes such as aging, comorbid conditions, or unrelated injuries.