Characterizing Sex Differences in Clinical and Functional Outcomes Among Military Veterans With a Comprehensive Traumatic Brain Injury Evaluation: A Million Veteran Program Study

Abstract

Using a diverse sample of military veterans enrolled in the Veteran Affairs (VA) Million Veteran Program (N = 14,378; n = 1,361 females [9.5%]; all previously deployed), we examined sex differences on the Comprehensive Traumatic Brain Injury Evaluation (CTBIE), a structured traumatic brain injury (TBI) interview routinely administered in VA health centers. Confirmed TBI diagnoses were more frequent among males than females (65% vs. 58%). In addition, compared with females, a greater proportion of males with CTBIE-confirmed TBI histories experienced blast-related injuries and were employed. In contrast, a greater proportion of females reported experiencing falls, sustaining a TBI since deployment, and having more severe neurobehavioral symptoms (particularly affective-related symptoms). Results indicate that males and females experience differential clinical and functional outcomes in the aftermath of military TBI. Findings underscore the need to increase female representation in TBI research to increase understanding of sex-specific experiences with TBI and to improve the clinical care targeted to this vulnerable population.