Age of First Exposure

Age at Start of Football Play Not Linked to Worse Health Later in Life

Does the age when you started playing football affect your health years after you leave the League? Although previous smaller studies have linked the start of football play before age 12 with poor cognitive health later in life, new research from Vanderbilt University Medical Center and our study challenges these previous findings. We asked our cohort of 4,100 players about the age they began playing football and their post-career health. The purpose behind these questions was to determine whether the age when they first began to play football was connected to health conditions later in life such as cognitive function, cardiovascular/metabolic health, and mood.

What did we learn?

Our analysis did not reveal a relationship between the age when former players began playing football and any health condition. Specifically, for former NFL players, we found no relationship between age of starting to play football and:

• Mood symptoms such as depression, anxiety, emotional dyscontrol (e.g., irritability, impatience, issues controlling temper)
• Cognitive symptoms, memory symptoms, ADHD, and dementia
• Chronic pain and headache
• Other conditions including high blood pressure, low testosterone, and sleep apnea

Why do our results seem different?

Our researchers have access to a large cohort of former players who have a diverse set of football experiences including various positions played, career lengths, and exposure to head injury, among other factors. Previous studies used smaller samples of select groups of players with specific qualities, for example only those who had active cognitive, behavioral, or mood symptoms.

We conducted this research for two reasons:

1. To help identify those players who might be most susceptible to certain conditions later in life
2. To conduct research on interventions and takeaways that the former player community might utilize to reduce the occurrence of these conditions that impact quality or length of life

Important notes:

• Because this study was conducted only among former professional players, these results only apply to this group. We note this because only a small percentage of football players make it to the NFL, which means they most likely have characteristics and practices that distinguish them from those who participated only at youth, high school, and collegiate levels. Differences in these levels may be related to lifestyle, psychological make-up, youth football experiences, exercise habits, and other areas.
• There are other factors related to youth football play that may still impact health later in life. For example, years played before going pro, use of pads during practice, and/or weight gain may be relevant for post-career health outcomes. Future studies should examine these other characteristics to see if they help us identify which former players might be at risk for certain conditions later in life.

Potential Action Steps for All Former Players

Regardless of when you began to play football, there are key steps that you can take to manage your health now and in the future:

• Speak to your doctor about checking on your heart, brain, hormone health, and sleep. Lifestyle changes (e.g., exercise, diet) and medications can have positive impacts on health. Use our checklist designed specifically for former players when speaking with your medical care provider.
• Know Your Numbers: It is important to monitor your blood pressure on a regular basis either at your doctor’s office or by using at-home blood pressure cuffs and discuss results with your doctor.
• If you think you may be experiencing symptoms of cognitive impairment, talk to your primary care physician (PCP) about getting a comprehensive neurocognitive evaluation from a neurologist or highly trained specialist. If you don’t currently have a doctor, check if you are eligible for the Trust (Powered by the NFLPA) or check out this website to get help finding a physician in your area.
• Hypertension, high cholesterol, and diabetes at any age can have long-lasting implications for heart and brain health. It is important to be proactive about maintaining healthy blood pressure through exercise, regular sleep, maintaining a healthy weight and diet, as well following medication-related, and lifestyle recommendations from your healthcare providers. See recommendations from the American Heart Association for maintaining health blood pressure.
• If you are concerned about your heart health, do not hesitate to contact your primary care doctor, or another medical care provider. You can find a cardiologist through the Trust powered by the NFLPA (check eligibility) or your primary care doctor.

If you have questions about this information, please email our team at players@footballplayershealth.harvard.edu or call us at 617-432-5000.