Football Players Health Study Publications

Playing in the NFL has been linked to chronic adverse health outcomes. The extent to which NFL players’ careers impact their spouses’ caregiver burden, depression, and anxiety remains unknown. In addition to conventional family stressors, NFL families may have specific concerns such as chronic traumatic encephalopathy (CTE; a condition that can only be established at autopsy), which may additionally contribute to caregiver burden and mood symptoms.

The study found that participants who reported their own health as poor also reported increased levels of caregiver burden, anxiety, and depression compared to those who rated their own health positively. Notably, participants who reported concerns about chronic traumatic encephalopathy (CTE) reported levels of caregiver burdenon par with that of military families, and higher than family members caring for partners with cancer, dementia, or of advanced age. Participants with a history of numerous relocations also reported increased caregiver burden. Higher ratings of marital satisfaction were linked to reduced caregiver burden, anxiety, and depression.

Please read our results return for more information and action items for NFL families.

Career duration is often used as a proxy metric of neurotrauma exposure in health studies of elite and professional athletes, likely due to ease of recall and verification using public records. However, important considerations related to its use in this setting have not been investigated.

In this study of former professional American-style football (ASF) players, former players with both the shortest and longest careers had comparatively lower risk of adverse health outcomes when compared with players with midrange career lengths. In addition, former professional ASF players with the longest careers reported fewer adverse play-related exposures (eg, concussion history and average number of snaps per game).

Relationships between ASF career duration and subsequent health status may be non-linear. Specifically, attenuation of associations among longer career players could be related to selection effects resulting in reduced susceptibility of longer career players to certain exposures or to career length serving as a poor proxy for true causal factors.

CTE, or chronic traumatic encephalopathy, is a real condition resulting from repetitive head injury that is identified on autopsy. Currently there is no test that can confirm whether a living person has CTE, nevertheless, former NFL players may be concerned that they have CTE. Our objective was to determine how many players shared this concern, and whether they had other conditions that cause cognitive symptoms that might mimic CTE symptoms. Lastly, we studied whether frequent thoughts of self harm or suicide were common in former players who believe they have CTE.

Please read our results return for more information and action items for former players.

Intraarticular knee injuries and subsequent posttraumatic arthritis (PTOA) are common in athletes. Unfortunately, PTOA may significantly affect performance and overall function, but this condition remains difficult to characterize. In this review, we provide an overview of imaging modalities used to evaluate PTOA among athletes and physically active individuals following knee injury, with the goal to discuss the strengths and limitations of their application in this population.

Prior studies examining small samples of symptomatic former professional football players suggest that earlier age of first exposure (AFE) to American football is associated with adverse later life health outcomes. Our study examined a larger, more representative sample of former professional American football players to assess associations between AFE before age 12 and clinical outcomes compared with those who started at age 12 or older.

In a large cohort of former professional (4,198) American-style football players, we found that AFE was not independently associated with adverse later life outcomes. These findings are inconsistent with smaller studies of former professional football players. Studies examining AFE in professional football players may have limited utility and generalizability regarding policy implications for youth sports.

Please read our results return for more information and action items for former players.

Mid-life cardiovascular risk factors are associated with later cognitive decline. Whether repetitive head injury among professional athletes impacts cardiovascular risk is unknown. We investigated associations between concussion burden and post-career hypertension, high cholesterol, and diabetes among former NFL players. We found that prior concussion burden is associated with post-career atherosclerosis cardiovascular risk profiles among former NFL football players.

Please read our results return for more information and action items for former players.

Despite being a postmortem diagnosis, former professional American-style football players report receiving chronic traumatic encephalopathy (CTE) diagnoses from medical care providers. However, many players also report other health conditions that manifest with cognitive and psychological symptoms. The purpose of this study was to identify how medical conditions, psychological disorders, and football exposure combinations are associated with former athletes reporting a premortem CTE diagnosis.

Clinical phenotypes including psychological disorders and sleep apnea were strongly associated with an increased likelihood of having received a pre-mortem CTE diagnosis in former professional football players. Depression, anxiety, and sleep apnea produce cognitive symptoms, are treatable conditions, and should be distinguished from neurodegenerative disease.

Despite being a postmortem diagnosis, former professional American-style football players report receiving chronic traumatic encephalopathy (CTE) diagnoses from medical care providers. However, many players also report other health conditions that manifest with cognitive and psychological symptoms. The purpose of this study was to identify how medical conditions, psychological disorders, and football exposure combinations are associated with former athletes reporting a premortem CTE diagnosis.

In conculsion, clinical phenotypes including psychological disorders and sleep apnea were strongly associated with an increased likelihood of having received a pre-mortem CTE diagnosis in former professional football players. Depression, anxiety, and sleep apnea produce cognitive symptoms, are treatable conditions, and should be distinguished from neurodegenerative disease.

Traumatic brain injury (TBI) is highly prevalent among individuals participating in contact sports, military personnel, and in the general population. Although it is well known that brain injury can cause neurological and psychiatric complications, evidence from studies on individuals exposed to a single or repetitive brain injuries suggests an understudied association between TBI and the risk of developing chronic cardiovascular diseases and risk factors for cardiovascular disease. Several studies have shown that people without pre-existing comorbidities who sustain a TBI have a significantly higher risk of developing chronic cardiovascular disease, than people without TBI. Similar observations made in military and professional American-style football cohorts suggest causal pathways through which modifiable cardiovascular risk factors might mediate the relationship between brain injury and chronic neurological diseases. A better understanding of cardiovascular disease risk after TBI combined with a proactive, targeted screening program might mitigate long-term morbidity and mortality in individuals with TBI, and improve their quality of life.

Traumatic brain injury (TBI) is highly prevalent among individuals participating in contact sports, military personnel, and in the general population. Although it is well known that brain injury can cause neurological and psychiatric complications, evidence from studies on individuals exposed to a single or repetitive brain injuries suggests an understudied association between TBI and the risk of developing chronic cardiovascular diseases and risk factors for cardiovascular disease.

Understanding the long-term cardiovascular disease risk after a TBI, combined with a targeted screening programme for cardiovascular risk factors might enhance the quality of life of individuals with TBI, but could also mitigate the risks for specific secondary neurological diseases.