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Prevalence of Dual Sensory Impairment and Its Association With Traumatic Brain Injury and Blast Exposure in OEF/OIF Veterans

Lew, Henry L. MD, PhD; Pogoda, Terri K. PhD; Baker, Errol PhD; Stolzmann, Kelly L. MS; Meterko, Mark PhD; Cifu, David X. MD; Amara, Jomana PhD; Hendricks, Ann M. PhD

The Journal of Head Trauma Rehabilitation: November/December 2011 - Volume 26 - Issue 6 - p 489–496
doi: 10.1097/HTR.0b013e318204e54b
Original Articles

Objective: To describe the prevalence of self-reported rates of auditory, visual, and dual sensory impairment (DSI) in Afghanistan and Iraq war Veterans receiving traumatic brain injury (TBI) evaluations.

Design: Retrospective medical chart review.

Participants: Thirty-six thousand nine hundred nineteen Veterans who received a TBI evaluation between October 2007 and June 2009. Final sample included 12,521 subjects judged to have deployment-related TBI and a comparison group of 9106 participants with no evidence of TBI.

Main Outcome Measure: Self-reported auditory and visual impairment.

Results: Self-reported sensory impairment rates were: 34.6% for DSI, 31.3% for auditory impairment only, 9.9% for visual impairment only, and 24.2% for none/mild sensory impairment. Those with TBI and blast exposure had highest rate of DSI. Regression analyses showed that auditory impairment was the strongest predictor of visual impairment, and vice versa, suggesting these impairments may derive from a common source.

Conclusions: Veterans who self-report clinically significant hearing or vision difficulty during routine TBI evaluation should be evaluated systematically and comprehensively to determine the extent of sensory impairment. Identifying DSI could allow clinicians to collaborate and maximize rehabilitation.

Defense and Veterans Brain Injury Center (DVBIC) (Dr Lew); Department of Physical Medicine & Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia (Drs Lew and Cifu); Center for Organization, Leadership and Management Research, VA Boston Healthcare System (Drs Pogoda, Baker, and Meterko and Ms Stolzmann); Department of Health Policy and Management, Boston University School of Public Health, Boston, Massachusetts (Drs Pogoda, Meterko, and Hendricks); Physical Medicine & Rehabilitation Service, Hunter Holmes McGuire VA Medical Center, Richmond, Virgina (Dr Cifu); Defense Resources Management Institute, Naval Postgraduate School, Monterey, California (Dr Amara); and Health Care Financing & Economics, VA Boston Healthcare System, Boston, Massachusetts (Dr Hendricks)

Corresponding Author: Terri K. Pogoda, PhD, Center for Organization, Leadership and Management Research, VA Boston Healthcare System, 150 South Huntington Avenue (152M), Boston, MA 02130 (

This article is based on work supported by the Office of Research and Development, Health Services R&D Service, Department of Veterans Affairs, through SDR 08–405. The study was reviewed and approved by the Institutional Review Board of the VA Boston Healthcare System.

The opinions expressed in this article are the authors' and do not reflect those of the Department of Veterans Affairs, the Veterans Health Administration, Health Services Research and Development, the Defense and Veterans Brain Injury Center or the Department of Defense.

Parts of this study were presented at VA Research Week, Boston, Massachusetts, April 28, 2010, and National Center for Rehabilitative Auditory Research, March 15, 2010, Portland, Oregon.

We thank Martin P. Charns, DBA (VA Boston Healthcare System); John A. Gardner, PhD (VA Boston Healthcare System), Katherine M. Iverson, PhD (VA Boston Healthcare System); Rachel Kimerling, PhD (VA Palo Alto Health Care System); Maxine H. Krengel, PhD (VA Boston Healthcare System); Gabrielle H. Saunders, PhD (Portland VA Medical Center); and Lynn Wolfsfeld, MPP (VA Boston Healthcare System) for review and comment on earlier versions of the article.

The authors declare no conflicts of interest.

© 2011 Lippincott Williams & Wilkins, Inc.