Monitoring cognitive function in the fatigued warfighter: A rapid review of cognitive biomarkers

ObjectivesDecreases in cognitive function impair occupational performance, reduce occupational safety, and increase musculoskeletal injury risk. The aim of this paper was to identify measures that may be used to monitor cognitive function in the warfighter.DesignA rapid review.MethodsA rapid search of Academic Search Complete, MEDLINE, PsycINFO, and SPORTSDiscus databases was conducted. Eligibility criteria: original peer reviewed research articles, written in English, published between 2002 and 2022, and using human participants with no health issues in military training environments or active service.ResultsOf the 248 articles screened, 58 full-text articles were assessed for eligibility and 29 included in the review. Of these, 16 papers presented data from multi-stressor military training environments, or experimental studies where simulated military tasks were being performed. Thirteen papers focused on an aspect of military work and the implications for cognitive function (i.e., physical load, periods of extended wakefulness or fatigue, and hypoxic conditions). The domains of cognitive function that were assessed (i.e. vigilance, reaction time, working memory, situational awareness, and decision-making) were somewhat consistent among studies.ConclusionsProlonged exposure to high-stress military environments compromises multiple aspects of cognitive function. These findings highlight the need for a suite of biomarkers to monitor cognitive function and assess the ability of military personnel to attend to and process mission-critical information and make appropriate decisions on the battlefield and other high-stress environments. Our findings suggest that a suite of common tests may provide useful information about cognitive function in the warfighter.