Dr. Jocelyn Kilgore , Psychiatrist, Medical Director Intrepid Spirit Center, Ft. Belvoir
1) Identify the rates of chronic disease and neurocognitive decline in service members with a history of concussion
2) Explain the role of lifestyle factors in chronic disease as drivers and mitigating factors and overlap with Intrepid Spirit University Pillars in highlighting these lifestyle factors
3) Recognize and apply the value of interdisciplinary teams in focused individualized care for patients with symptoms persisting after concussion.
Reports of traumatic brain injury (TBI) in service members remain high despite the ending of the wars in Iraq and Afghanistan. Since 2020 there have been 468,424 reports of TBI in the Department of Defense. Additionally, service members who deployed and reported one or multiple incidents of a mild TBI (mTBI) continue to serve and may only present for medical care towards the end of their career. The rates of chronic disease in service members are higher than that of their civilian counterparts. Many aspects of the military life may contribute to this including the physical toll of military service on an individual’s body, chronic stress due to deployments and operational tempo, and chronic poor sleep related to long hours and shift work. The typical patient seen at ISC FB may report cognitive decline and often attributes it to a remote history of one or multiple mTBI events. While mTBI is a precipitating event (or multiple events with multiple precipitating episodes), most patients also report years of poor sleep, poor diet, pain, avoidance of movements that might cause pain, stress, and lack of connection. These lifestyle factors contribute to the phenotypic expression of an individual’s brain and body health. Additionally, evidence supports the role of the interdisciplinary team in the treatment of symptoms persisting after concussion. At the Intrepid Spirit Center at Fort Belvoir (ISC FB), this knowledge informs the development of individualized interdisciplinary treatment plans for patients. Within the Intrepid Spirit University (ISU) model, patients are “students” responsible for learning in the context of Six Pillars of Brain Health: Sleep, Nutrition, Pain Management, Physical Movement, Resiliency, and Connectedness. Framing the individualized interdisciplinary treatment plan in the context of modifiable lifestyle factors allows the student to gain control of their health and to make choices that can influence their current and future health with the goal of optimizing brain/body health and enhancing performance.