Traumatic brain injury in veterans of the wars in Iraq and Afghanistan: Communication disorders stratified by severity of brain injury

Abstract

Objective: To describe the prevalence of communication disorders in veterans of the wars in Iraq and Afghanistan with traumatic brain injury (TBI).

Design: Retrospective study of the prevalence of aphasia, fluency and voice disorders among veterans with different severity levels of TBI. Data was obtained from the VA National repository for OEF/OIF/OND veterans who received VA care in Fiscal Years 2010 and 2011.

Results: Among the 303 716 veterans in this study, 1848 were diagnosed with a communication disorder; 40% of these were also diagnosed with a TBI. Voice disorders were the most prevalent diagnosis (3.5 per 1000) followed by aphasia (1.9 per 1000) and fluency disorder (0.7 per 1000). Individuals with a TBI diagnosis were more likely to have a diagnosis of aphasia, followed by fluency and then voice disorder. The odds ratio (OR) of aphasia with TBI was 11.09–252.75 (95% CI = 8.78–441.52, p < 0.01). OR for fluency disorders with TBI was 3.58–10.41 (95% CI = 2.56–42.40, p < 0.01) and association of voice disorders with TBI was significant for all levels of TBI severity (OR = 1.5–6.61, 95% CI = 1.24–14.05, p < 0.01).

Conclusions: Veterans who sustained a TBI were more likely to have a diagnosis of a communication disorder, regardless of TBI severity. Those with TBI, including mild TBI, should be screened and evaluated for communication disorders.

• aphasia
• epidemiology
• fluency disorder
• TBI severity
• Veterans Health Administration
• voice disorder

Acknowledgements

The authors acknowledge and appreciate support from the South Texas Veterans Healthcare System/Audie L. Murphy Division and the Edith Nourse Rogers VA Memorial Hospital. We also acknowledge assistance with manuscript preparation by Barbara Elizondo and Kathleen Franklin as well as valuable input by Dr Juan Cabrera at the initial stages of the manuscript process. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.