Former professional football players who reported experiencing concussion symptoms during their careers were found to perform worse on a series of cognitive tests than non-players, according to a study led by Mass General Brigham researchers from McLean Hospital and Spaulding Rehabilitation Network. The results of the study are published on March 2n.dinNeuropsychologist Clinic Archivey.
Of 350 former National Football League (NFL) players studied an average of 29 years after their careers ended, those who reported experiencing concussion symptoms during their careers scored worse on assessments of episodic memory, sustained attention, processing speed and vocabulary. However, the number of concussions diagnosed by a medical professional or the length of their career had no effect on cognitive function.
A follow-up analysis compared ex-players to more than 5,000 male volunteers in the general population who did not play professional football, which found that cognitive performance was generally worse for ex-players than non-players. While younger ex-players performed better than non-players on some tests, older retired players were more likely to perform worse than controls on cognitive tasks.
The researchers who led the study said their results underscore the importance of monitoring concussion symptoms as opposed to diagnosed concussions in research. This work also adds to evidence of the impact that a professional football career can have on accelerating cognitive aging.
“It’s well established that in the hours and days after a concussion, people experience some cognitive impairment. However, when you look decades out, the data on long-term impact are mixed,” said senior study author Laura Germine. PhD, director of the Brain Technology and Cognitive Health Laboratory at McLean Hospital and associate professor of psychiatry at Harvard Medical School. “These new findings from the largest study of its kind show that professional soccer players can still experience cognitive difficulties associated with head injuries decades after they retire from the sport.”
Concussion symptoms associated with cognitive performance
For the study, 353 retired NFL players completed hour-long neuropsychological tests through an online platform called TestMyBrain, which is supported by McLean Hospital and Harvard Medical School. Players were fully remote and completed tests on a laptop or desktop computer that included assessments measuring processing speed, visual-spatial and working memory, as well as aspects of short- and long-term memory and vocabulary.
Discovered concussion symptoms were measured by asking players how often they experienced any of the following symptoms after a hit to the head during a game or practice: headaches, nausea, dizziness, loss of consciousness, memory problems, disorientation, confusion, seizures , vision problems or feeling unsteady on their feet. They were also asked if they had lost consciousness during their career and if they had ever been diagnosed with a concussion by a medical professional.
The results showed that the former players’ cognitive performance (for example, on memory tasks) was associated with recalled football concussion symptoms. For example, the differences observed in visual memory scores between former players with the highest and lowest reported concussion symptoms were equivalent to the differences in cognitive performance between a typical 35-year-old and 60-year-old.
However, poor cognitive performance was not associated with diagnosed concussions, years of professional play, or age of first football exposure. The researchers noted that many head injuries or subconcussive hits may go undiagnosed as concussions due to a lack of awareness at the time or underreporting of symptoms by players.
When we compared the retired players to a group of 5,086 men who did not play football, cognitive performance was generally worse for the former players. On two tests of processing speed, age-related differences in cognitive performance were larger among the former gamer group than the nongamer group, with older players performing worse.
These comparative data suggest that exposure to soccer may accelerate age-related cognitive declines and cause greater disadvantages at older ages, according to the researchers, who added that more studies are needed to track the cognitive performance of former players as they grow older. Another possibility is that improved awareness and management of head injuries may have spared younger retired players more than older ones. The researchers also noted that this comparative finding is limited by the lack of data on cognitive function before head injuries and that more research is needed that closely matches former players and non-players and measures their cognitive performance across time. of their lives.
“For both former players and researchers, we can glean some important takeaways from this study,” said Soccer Player Health Study principal investigator Ross Zafonte, DO. “Former players can support their cognitive health as they age by taking preventative measures and continuing to counsel their providers and educate themselves about head injury symptoms. For researchers and providers, these findings support efforts to develop ways to improve of the diagnosis and determination of long-term sequelae of concussion.” Zafonte is president of the Spaulding Rehabilitation Network, a Mass General Brigham sports medicine physician, and the Earle P. and Ida S. Charlton Professor and Chair of the Department of Physical Medicine and Rehabilitation at Harvard Medical School.
“The Community-Based Participatory Research (CBPR) approach adopted in this study is where this field is headed,” said Germine. “We’re grateful to the players and how much they’ve taught us. It wouldn’t be possible to do a study like this without engaging and deeply involving their community.”
Evidence-driven research from former NFL players
The Football Players Health Study at Harvard University, launched in 2014, is a comprehensive research program dedicated to examining the multifactorial causes affecting the health of former NFL players. The research has been informed by the players themselves, who have provided insight into the health concerns and conditions they face following a career in football. A multidisciplinary team of researchers from Harvard University and Harvard Medical School and its affiliated teaching hospitals, including those in the Mass General Brigham system, conducts research from neurology, cardiology, sports medicine, rehabilitation medicine, chronic pain and public health. While concussion and head injury are of utmost concern, the study looks at all aspects of player health across the lifespan. Former players can find important resources to support their health in this section of the study website.