We're committed to providing excellence in care for those who serve America and sustain a TBI or low-level blast injury. There are a few reasons for a more concentrated focus on warfighter brain health.

Combat training and extended operations effect the brain health of our forces. The DOD needed a unified approach to brain health that spans across military health, weapons development, intelligence, and warfighters in all operating environments.

The field has and will benefit from more knowledge about identifying, monitoring, and mitigating brain exposures and threats. Competing, deterring, and winning in all operational environments means discovering how to strengthen thinking abilities and physical skills in our warfighters.

One of the biggest ways to alleviate the detrimental effects of TBI is through early detection. The initiative focuses on raising awareness and providing better education about (mild) mTBI, otherwise known as a concussion.

Knowing the signs and symptoms can help with early detection, which allows for early treatment and supports the best possible outcome for the Warfighter. DOD policy supports this framework.

Currently the DOD conducts cognitive monitoring in the pre-deployment setting. That monitoring will expand throughout the career of the service member, for regular and ongoing monitoring, to identify and address any cognitive changes as soon as they are known.

Blast overpressure is the “wave” that is felt after firing a weapon or munition. When a blast overpressure wave occurs, there can be some impacts that affect thinking skills, balance changes and other brain health issues.

Low-level blast exposure is generated from firing heavy weapon systems or explosives in combat or training environments. Concerns regarding repetitive sub concussive blast exposures and their effects on brain health have results in significant research investments which have already furthered our understanding of these relationships.

Symptoms from low-level blast exposure usually resolve with time and can include:

• Concentration problems.
• Difficulty hearing.
• Headaches.
• Memory problems.
• Slowed thinking or reaction times.
• Decreased hand-eye coordination.

The DOD has been evaluating units for brain health and performance effects of blast overpressure. The United States Special Operations Command is out front leading the way with implementing support activities that address brain health needs in all environments.

Emerging information from acute and repetitive exposures to blast has shown adverse effects, such as the inability to sleep, degraded cognitive performance, headaches and dizziness.

Our commitment to force health protection and sustaining Warfighter readiness is to understand, prevent, accurately diagnose, and promptly treat blast overpressure and effects in all its forms.

Current information about the effects of weapons and munitions on health focuses on the ears and lungs. We know that repetitive exposure to blast overpressure may cause changes in thinking abilities.

Efforts to accelerate what we are learning from blast research into a real and immediate benefit for the warfighter are underway. The program will help standardize how we approach brain health to help warfighters:

• Maintain readiness.
• Optimize thinking.
• Enhance/improve physical performance.

Commanders are responsible for implementing policy guidance to help ensure their units reach and maintain peak performance capability to support deployments and mission critical activities. Many of the actions in our plan will also be relevant for service members who are training with their units to become the strongest warfighter possible.

Measures of success will connect to data for each of the areas. For example, the full implementation of the cognitive monitoring program will apply for active duty service members and members of the National Guard and Reserve Components. Once documented, interventions can occur to maximize brain health.

Goals include, as follows:

• Optimize warfighter cognitive and physical performance.
• Identify, monitor, and mitigate brain exposures.
• Prevent, recognize, and minimize the effects of traumatic brain injury.
• Reduce or eliminate long-term/late effects.
• Advance Warfighter brain health science.

As we ramp up greater implementation, education, training, and operational rotations, we'll have more data and other relevant information.

Service members should stay engaged and informed through their leadership and command chains of command.

DOD leaders finalized the plan in June 2022. Over the next few years, service members will begin to see information about cognitive testing, best practices, and updated policies focused on brain health and performance.

A unified approach to cognitive monitoring means service members will complete cognitive function tests upon entry and every five years. DOD can use the baseline information to proactively sustain and extend the lifecycle of the force. Data will provide an opportunity to enhance or restore cognitive performance based on the individual’s cognitive status.

The total force will obtain a baseline test every five years. This is scheduled to start in June 2024.

AHIs are brain threats that can lead to a clinical condition like TBI in terms of symptoms, assessment findings, and treatments that may be effective.

AHIs are a brain threat and a priority for the Department because they affect the safety, health, and welfare of DOD personnel and their families. Early reporting is the best method for accessing appropriate treatments for brain injuries.