Clinical, Cognitive, and Genetic Predictors of Change in Job Status Following Traumatic Brain Injury in a Military Population

Objective: Traumatic brain injury (TBI) is a risk associated with military duty, and residual effects from TBI may adversely affect a service member's ability to complete duties. It is, therefore, important to identify factors associated with a change in job status following TBI in an active military population. On the basis of previous research, we predicted that apolipoprotein E (APOE) genotype may be 1 factor. Design: Cohort study of military personnel who sustained a mild to moderate TBI. Setting: Military medical clinics. Patients or Other Participants: Fifty-two military participants were recruited through the Defense and Veterans Brain Injury Center, affiliated with Naval Medical Center San Diego and the Defense and Veterans Brain Injury Center Concussion Clinic located at the First Marine Division at Camp Pendleton. Intervention(s): A multivariate statistical classification approach called optimal data analysis allowed for consideration of APOE genotype alongside cognitive, emotional, psychosocial, and physical functioning. Main Outcome Measure(s): APOE genotype, neuropsychological, psychosocial, and clinical outcomes. Results: We identified a model of factors that was associated with a change in job status among military personnel who experienced a mild or moderate TBI. Conclusions: Factors associated with a change in job status are different when APOE genotype is considered. We conclude that APOE genotype may be an important genetic factor in recovery from mild to moderate head injury.