Neuropsychological predictors of functional disability in Gulf War Illness.

Functional disability refers to the degree to which a health condition impacts day-to-day physical, social, and emotional functioning. Veterans with Gulf War Illness (GWI) may be particularly at risk for developing high functional disability due to their illness. However, few have examined potential factors associated with functional disability in GWI. Cognitive impairment is potentially one determinant of functional disability. Moreover, cognitive impairment is one of the core symptoms of GWI. Thus, the current study proposed to examine neuropsychological and deployment-related correlates of functional disability in veterans with GWI. Data from N = 28 veterans with GWI were used for the current study. We hypothesized that three neuropsychological domains impaired in GWI—verbal memory, visuospatial ability, and working memory—would significantly predict functional disability over and above deployment trauma (probable PTSD and depressive symptoms). Hierarchical linear regression suggested our hypothesis was only partially supported. The combination of neuropsychological predictors did not account for a significant addition of variance (ΔR2 = .85, F(8, 25) = 1.73, p = .163), with deployment trauma accounting for the majority of variance (b = .43, SE = .05, p < .001). However, immediate visuospatial memory (b = -.02, SE = .01, p = .037) and visuospatial organizational ability (b = .01, SE = .00, p = .040) were both significantly associated with functional disability in the full model (R2 = .90, F(10, 17) = 14.55, p < .001). Our results suggest that veterans with GWI could benefit from treatment targeting both mental and cognitive health in addition to typical treatment targeting physical symptoms. Historically, veterans with GWI have struggled to find appropriate support and treatment for their illness. Identifying factors impacting their day-to-day functioning will help target resources to this underserved population.