Results: Concussion, Playing Experience, and Long-Term Health

One of our Study’s priorities is to better understand the health impacts of concussion. Another is to identify how particular NFL playing experiences affect health outcomes. The findings below shed light on both of these topics, showing how concussions, NFL career length, and playing position may impact your long-term cognitive and mental health. You will also find some action steps and resources to help you be proactive about these aspects of your health.

What the Science Says
Our analysis of 3,500 former NFL players looked at individuals’ current cognitive and mental health alongside the specific exposures they encountered during their NFL careers, using the health and playing data that former players reported on themselves in our First Health and Wellness questionnaire (Q1). Here’s what we found:

• Concussion Symptoms: Former players who reported more concussion symptoms during their NFL playing years (loss of consciousness, disorientation, nausea, etc.) were significantly more likely to report having cognitive impairment¹, depression, and anxiety later in life.
• Playing Position: In comparison to men who played positions with the lowest concussion risk (kicker, punter, and quarterback), running backs, linebackers and special teams² positions were over twice as likely to report having cognitive impairment and 40% more likely to report depression. Wide receivers, defensive backs, linemen and tight ends were 70% more likely to report cognitive impairment and 40% more likely to report depression when compared to the lowest risk group.
• Years of Play: Having a longer NFL career significantly increased risk of cognitive impairment and depression later in life. With each five years of play, risk for cognitive impairment increased by 20%, while risk for depression rose by 9%.

¹In this study, cognitive impairment was defined as frequent and regular problems with memory, concentration, and attention, as well as difficulty processing and understanding basic information.

²This group includes all special teams’ positions except for kickers and punters. Kickers and punters were assessed as a separate group, alongside quarterbacks.

This is the first large-scale study to quantify the specific risks associated with NFL career length and playing position, and an important step in beginning to understand how playing exposures may impact health. However, more research is needed on this topic before any definitive conclusions can be drawn. Additionally, it is important to understand that there are a number of different variables that affect cognitive health, and that many individuals who had the playing exposures outlined above will not experience cognitive impairment or poor mental health. As the graph below illustrates, even among those players who experienced the highest levels of exposure (i.e., individuals who played for seven seasons or more in high-risk positions), the percentage of men who reported cognitive impairment did not exceed 16%.

Potential Action Steps
Although you cannot change your NFL playing experience, there are things you can do to be proactive about your cognitive and mental health now:

• Depression and anxiety are common and treatable health conditions that can negatively impact cognitive function. If you think you may be experiencing depression or anxiety, talk to your doctor about these concerns and how you can address them. If you need to speak with someone immediately or need help finding a doctor, contact the NFL Life Line, described in detail below.
• If you think you may be experiencing symptoms of cognitive impairment, talk to your doctor about getting a comprehensive neurocognitive evaluation. With proper diagnosis and management, people with cognitive impairment can live happy and fulfilling lives. If you don’t currently have a doctor, contact the NFL Life Line to get help finding a physician in your area.
• There are many ways to maintain and improve your cognitive health. For example, getting good-quality sleep, regular exercise, and maintaining a healthy diet and weight are all known to enhance cognitive function. Continually challenging your brain to stay active and learn new skills is also known to positively impact cognitive health. If you would like to learn more about specific techniques and strategies for enhancing cognitive health, contact us for a copy of Harvard’s Guide to Cognitive Fitness or consult your physician.
• Cognitive function and mental health can be negatively affected by certain physical conditions that disproportionately impact former players, such as sleep apnea and heart disease. Talk with your doctor about getting a comprehensive health evaluation so that you can be evaluated for any conditions that may be impacting these and other important areas of your health.

Resources

• NFL Life Line: This is a free, independent, and confidential phone consultation service that is available to former players and their families 24 hours a day, 7 days a week. It is designed to help individuals with any mental or physical health matters that they need support on, and to connect them with the resources they need. The Life Line is run by professionals who are trained to assist individuals experiencing personal or emotional crises. Contact: (800) 506-0078.
• Players Assistance & Counseling Services: This benefit provides eligible former players and their families with up to eight free counseling sessions a year for matters ranging from family/marital concerns to depression. Contact: (866) 421-8628.
• The Trust: Information on Depression: This resource provides an overview of depression symptoms and treatments, as well as resources to help former players experiencing depression.
• NFLPA: Myths about Depression and Anxiety: This resource discusses and debunks common myths about depression and anxiety.

If you have questions about the information above or would like to learn more about the Study, please call us (617.432.5000) or email us.

Read the paper: Exposure to American Football and Neuropsychiatric Health in Former National Football League Players