Introduction: Brain fog may decrease quality of life (QOL) in Veterans with pain by reducing cognitive capacity and functional engagement. Veterans with higher pain interference (PI) experience worse QOL. Given PI’s relationship with QOL, it is important to explore brain fog within the context of PI levels. This study compared health-related QOL, functional cognition, and functional abilities between Veterans with high versus low PI and brain fog. Method: A cross-sectional study, using a one-way MANOVA, explored whether Veterans with brain fog and pain symptoms perceived PI-affected measures of QOL. Exploratory post hoc testing compared gender differences and correlations between perceived confidence with abilities and QOL. Results: Thirty-four Veterans participated. The results of the MANOVA showed a significant main effect of PI between constructs. Univariate tests revealed differences in physical health, symptoms of mental health issues, and perceived confidence with abilities. No differences in outcomes based on gender were found. The exploratory correlation analysis demonstrates that in Veterans with brain fog and painful symptoms, there are high correlations between physical health and perceived confidence with abilities and moderate correlations between mental health and perceived confidence with abilities, and between functional cognition and perceived confidence with abilities. Discussion: Veterans with pain symptoms and brain fog with high PI demonstrated more mental health symptoms, poorer physical functioning, and reduced perceived abilities. Results from the correlation analysis demonstrate that perceived confidence plays a role in QOL. This study contributes to the overall understanding of this experience, identifying evidence-based suggestions for future exploration.
Lay summary Brain fog is a symptom of pain that can affect how Veterans do their daily activities. Veterans describe brain fog as variable changes in their thinking and feeling (e.g., anger). Not a lot of information is known about how brain fog impacts the quality of life of Veterans with pain symptoms. To learn about the impacts of brain fog on quality of life, we compared three outcomes of quality of life in two groups of Veterans. The outcomes we looked at were health-related quality of life, functional cognition, and perceived confidence with abilities. The first group was Veterans with brain fog and low pain interference. The second group was Veterans with brain fog and high pain interference. A total of 34 Veterans were involved in this study. We found that Veterans with brain fog and a high level of self-reported pain interference had more self-reported mental health symptoms, less physical abilities, and less confidence with their abilities. This is the first study exploring brain fog experiences in Veterans with pain symptoms and brain fog. It shows how the experience of high pain interference and brain fog might impact the quality of life of Veterans.