SEX DIFFERENCES IN FUNCTIONALITY AND SYMPTOM BURDEN ON LIFE SATISFACTION AMONG VETERANS WITH MILD TRAUMATIC BRAIN INJURY

Research Objectives: Describe sex differences in the association of functionality and symptom burden on life satisfaction among Veterans with chronic mTBI.

Design: Retrospective cross-sectional analysis of existing clinical data.

Setting: Outpatient data from the Polytrauma Rehabilitation Center at the South Texas Veterans Health Care System.

Participants: The sample was comprised of Veterans who had sought outpatient care at the Polytrauma Rehabilitation Center between 2015 and 2020.

Interventions: Not applicable.

Main Outcome Measures: Mayo-Portland Adaptability Inventory-4 (MPAI-4) Participation Index (M2PI; Functional Impairment), the Neurobehavioral Symptom Inventory (NSI; symptom burden) and Satisfaction with Life Scale (SWLS).

Results: Of these 1209 Veterans, only 8.7% (N=106) were women. Overall, Veterans reported being ‘slightly dissatisfied’ with life (M=16.99). A forward linear regression using individual M2PI and NSI items was conducted to identify which had the greatest association with life satisfaction among each of the sexes. Among both sexes, the NSI item on ‘feeling depressed’ had the strongest association with life satisfaction; explaining 19% of variability among women and 26% in men. However, the next best association in women was with nausea symptom burden (7% variability explained) while engagement in recreational activities was the next strongest factor in men (8% variability explained).

Conclusions: Regardless of sex, burdensome symptoms of depression had the greatest association with life satisfaction. However, divergences in the next strongest associations reveal more tailored opportunities to increase satisfaction with life and general well-being. For women, this may be renewed interest in addressing symptoms like nausea, for which etiology has been notoriously difficult, symptom management onerous, and frequently concomitant disability. For men, healthy and positive recreational engagement may be revealed as a more efficacious approach to enhancing life satisfaction following military service. Particularly in the context of the COVID-19 pandemic, increasing engagement in healthcare for both sexes and recreational activities for men could substantially impact life satisfaction in the chronic phase following mTBI among Veterans.

Author(s) Disclosures: The Authors acknowledge the support of the Department of Veterans Health Affairs with the collection of this data. There is no funding to report.