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CTE Concerns in Former NFL Players

September 23, 2024
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CTE, or chronic traumatic encephalopathy, is a real condition resulting from repetitive head injury that is identified on autopsy (after someone passes away).

Despite the fact that there is no test today that can confirm whether a living person has CTE, former NFL players may nevertheless 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 (trouble with memory, concentration, planning, and moodiness) 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.

What did we learn?


  • 35% of Study participants report believing that they have CTE.
  • Among these former players, those with pain, low testosterone, depression, behavioral instability, cognitive symptoms, and higher recalled concussion exposure were significantly more likely to report concerns about CTE.
  • Among this group who believe they have CTE, 25% reported frequent thoughts of suicide or self-harm. For those without CTE concerns, 5% reported frequent thoughts of suicide or self-harm.
  • As we see in studies in the general population, depression was the most significant suicidality risk factor for those with and without CTE concerns.
  • Even after taking depression, anxiety, and other risk factors for suicidality into account, those who expressed concerns about CTE were twice as likely to have frequent thoughts of self-harm or suicide.
  • There were players who didn’t think they had CTE but reported frequent thoughts of suicide or self-harm. This was most common among
  • Former players reporting experiencing headaches.
  • It is possible that the CTE-related brain changes are present in the men who have reported CTE diagnoses or concerns, and among those who do not. However, until clinical guidelines and treatments become available, former players and their physicians should explore treatments and positive health behavior changes that have been shown to improve cognitive function and quality of life.
  • Weight loss, exercise, a low-salt diet, improving sleep and other positive health behaviors may reduce cognitive symptoms and improve cognitive function.

It’s possible that you, a former teammate, friend, or loved one may be concerned about having CTE or have been given a diagnosis of CTE. Such diagnoses and/or concerns may have understandably led to confusion, anxiety, or uncertainty. We’ve shared resources at the bottom of this email to help you navigate any concerns with a doctor or on your own.

Did you know?

  • Other conditions commonly found in former football players may produce symptoms that have been attributed to CTE. Those symptoms, including difficulty with memory and concentration, mood swings, irritability, and confusion, can also be caused by sleep apnea, chronic pain, use of prescription pain medication (e.g., opioids), hypertension, diabetes, obesity, and more.
  • While these conditions can lead to a decline in cognitive function, managing or treating them has been shown to improve cognitive health (memory, thinking, concentration, mood swings) in measurable ways.

It is also possible that some former players in our study have the underlying brain changes associated with CTE. Whether the symptoms they are experiencing are eventually tied to CTE or not, we believe that doctors should still be prioritizing health issues that can be managed or treated. Below are some steps former players can take when discussing symptoms with their physicians, as well as other resources for improving cognitive health today.

What you can do with a doctor or specialist

If your clinician suggests that you may have CTE, ask if you have been tested for the following conditions that can affect cognitive function:

  • High blood pressure
  • Diabetes or high blood sugar
  • Sleep apnea
  • High cholesterol
  • Other heart conditions
  • Low testosterone
  • Depression

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, contact The Trust (Powered by the NFLPA) or use our checklist to get help finding a physician in your area.

To learn more about your health during a visit to the doctor:

  • Ask questions
  • Don’t be afraid to question a CTE diagnosis
  • Seek second opinions from specialists
  • Follow through and follow up with your physicians

It is important that your physician listens to you. Your PCP should be someone you trust, who understands your background, and with whom you can work.

What you can do on your own

Physical exercise has been shown to be effective in improving cognitive health and quality of life:

  • Ask your physician to recommend specific exercises and lifestyle choices known to provide cardiovascular benefit while limiting wear and tear on joints, especially if you’ve had a prior ACL tear or joint injury.
  • Even if you are not going to the gym, find resources for working out indoors. On YouTube, FitnessBlender and Yoga with Adriene are two great channels that have been keeping the study team active. Furthermore, EXOS’s feed on X includes creative ways to stay healthy at home.

Train your brain:

  • Try a different walking route around your neighborhood or find a Sudoku puzzle to keep your brain sharp.
  • 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.

Reach out to your social circle:

  • Maintaining a healthy social life with friends and family has been shown to improve cognitive function, physical health and even extend the lifespan.
  • Arrange a hangout with friends through Zoom or FaceTime to strengthen these vital connections.

Cognitive symptoms can understandably raise concerns about CTE in former players. However, we want these symptoms to prompt a call to a doctor or specialist, to spark a demand for quality, evidence-based healthcare, and to serve as motivation to improve diet, increase physical activity and reconnect with friends and loved ones.

Further Resources

  • The CDC fact sheet, Answering Questions About Chronic Traumatic Encephalopathy (CTE), provides useful information regarding CTE, CTE diagnosis, and more.
  • Medical/Wellness Assessment from The Trust (Powered by the NFLPA)
    • Brain and Body Assessment is an integrated and individually tailored assessment offered by premiere medical institutions for players to obtain a thorough, in-depth evaluation of their overall health. Following the assessment, players will receive a recommendation containing a plan of action that each player can follow after his visit. Learn more on their website.
  • Sleep apnea or other sleep problems may affect cognition and mood. Check out this resource on sleep apnea and consider consulting your doctor about a sleep evaluation that may help you to learn more about your own sleep.
  • NFL Life Line 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. The Life Line is run by professionals who are trained to assist individuals seeking resources for mental or physical health concerns or who are experiencing personal or emotional crises. You can call (800) 506-0078 or visit their website to chat with a trained counselor.
  • The Players Assistance & Counseling Services 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. You can call (866) 421-8628 or visit their website.