Army says nearly all soldiers have now taken new cognitive test for brain injuries

Nearly every soldier in the Army has completed the military’s new test meant to track cognitive health and the potential effects of explosive blast exposure, officials said Monday.

Army officials said 97% of soldiers have taken the Neurocognitive Assessment Tool, a computer-administered assessment that establishes a baseline for cognitive function. Doctors and specialists can later reference that baseline to track cognitive issues if a soldier suffers a blast overpressure injury.

Blast overpressure is the sudden increase in air pressure produced by explosions and the firing of certain heavy weapons, including artillery and other weapons routinely used by troops in training and combat. Repeated exposure to those pressure waves has been linked to brain injuries and cognitive problems.

The pressure waves can travel through the skull and interact with brain tissue, potentially causing injury even when a service member has not suffered a conventional blow to the head.

Research has associated repeated blast exposure with changes in brain structure and function, as well as symptoms including headaches, dizziness and memory problems.

Previous military data has also raised concerns about the mental health of troops routinely exposed to blasts. From 2019 to 2021, Army mortarmen had a suicide rate 40% higher than soldiers who did not use high-explosive weapons, according to data previously reported by The Assembly, a North Carolina-based news site. Three of the five Army occupations with the highest suicide rates routinely exposed soldiers to blasts.

The Defense Department established the test in 2024 as a required cognitive baseline assessment to monitor and track soldiers’ brain health and support recovery from traumatic brain injuries. Soldiers across the active-duty Army, Army National Guard and Army Reserve are required to take the assessment every three years.

Soldiers in career fields that routinely deal with heavy blasts, including field artillery, combat engineers and explosive ordnance disposal technicians, will have to meet additional testing requirements and must take the assessment annually.

New recruits are now also  taking the assessment upon entering the military. Soldiers will also take the test before deployment and following an injury or suspected concussion. The test tracks cognitive functions including memory and reaction time.

The cognitive baseline gives medical providers a point of comparison for later assessments, allowing them to identify changes in a soldier’s cognitive performance following potential exposure or injury.

Testing has been tried and dropped before

There is precedent for the Army to establish cognitive testing but to fail to use it in later health care.

The Assembly reported in 2024 that an artillery unit sent to Iraq in 2016 received neurological assessments before deploying. But soldiers from the unit said they did not receive required post-deployment testing after returning. The soldiers said the deployment had exposed them to repeated blasts.

The NCAT is part of a broader Army effort to address blast overpressure and low-level blast exposure, which the service has identified as occupational safety and health hazards. The Army plans to publish a service-wide directive outlining a broader overpressure program that includes exposure tracking, risk mitigation, cognitive monitoring, injury reporting and training.

Jordan Gillis, the assistant secretary of the Army for installations, energy and environment, said establishing a cognitive baseline allows the Army to monitor soldiers’ brain health and could help medical providers with treatment when needed.

Gillis, an Army Reserve field artillery officer who received a Purple Heart for injuries sustained while deployed in support of Operation Enduring Freedom, acknowledged that many soldiers from the wars in Iraq and Afghanistan were subjected to repeated blasts, including from improvised explosive devices and heavy weapons.

“I am from the era of Soldiers who grew up in the height of the global war on terror, and many of us were exposed to blast overpressure through things like IED attacks,” Gillis said. “I myself experienced several IED attacks, and so I believe from personal experience that this is important to do.”

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