B - 24 Assessing Cognitive Impairment within a High-Blast Risk Military Force

Abstract Objective Explosive Ordinance Disposal (EOD) is a military occupational specialty that is particularly high risk for blast exposures as well as psychologically traumatic combat experiences. We explore cognitive performance, symptom profiles, and blast exposure history of this group. Methods Participants were recruited from an active duty TBI rehabilitation center. Of 123 participants, 12 were EOD (Other N = 111). Learning and memory (HVLT-R), sustained attention (PASAT) and executive functioning (DKEFS) were assessed. A Global Deficit Score (GDS) was calculated to determine impairment. Neurobehavioral symptoms (NSI), PTSD and depressive symptoms (PCL-M and PHQ-8), combat (CES) and blast exposures (BETS) history were also assessed. Results When comparing EOD to Other, age, number of mTBIs, and blast exposures were comparable (p’s > 0.05). There was a trend for EOD to report fewer symptoms and more combat deployments. EOD reported greater exposure to combat (CES p = 0.004, d = 0.90) and performed stronger cognitively. HVLT-R-Total (EOD M = 48.50, SD = 9.46; Other M = 39.13, SD = 11.67; p = 0.008, d = 0.82), HVLT-R-Delayed (EOD M = 45.75, SD = 11.11, Other M = 38.61, SD = 13.76; p = 0.09, d = 0.53) and PASAT (EOD M = 54.10, SD = 7.37; Other M = 46.56, SD = 10.21; p = 0.014, d = 0.76). 50.4% of the overall sample and 16.7% of the EOD sample were determined to have cognitive impairment (GDS p = 0.015). Conclusions Results highlight the importance of baseline assessment for higher functioning specialized populations. EOD performed better than general forces on cognitive measures, including memory domains previously identified to be impacted by blast exposures. EOD presents with greater kinetic combat experiences that expose them to psychologically traumatic events despite reporting fewer symptoms. Most notable is the high rate of cognitive impairment in an active military force.