Football Players Health Study Publications

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.

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.

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.

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.

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.

Through our research, we’ve observed that Black and white players don’t always share the same post-career health experience. Our researchers investigated why these health disparities may be occurring. Using data from more than 20,000 players, we examined demographic trends in position and race from 1960 to 2020.

To analyze patterns in player position and career duration, we relied on a unique data set documenting race, position, and career length for all NFL players who played during that time period. While changes in the racial makeup in the NFL over the past several decades have been widely known and discussed, this is the first-time evidence is being presented via our analysis.

The burden of pain is unequal across demographic groups, with broad and persisting race differences in pain-related outcomes in the United States. Members of racial and ethnic minorities frequently report more pervasive and severe pain compared with those in the majority, with at least some disparity attributable to differences in socioeconomic status. Whether race disparities in pain-related health outcomes exist among former professional football players is unknown. We examined the association of race with pain outcomes among 3995 former professional American-style football players who self-identified as either Black or White. Black players reported more intense pain and higher levels of pain interference relative to White players, even after controlling for age, football history, comorbidities, and psychosocial factors. Race moderated associations between several biopsychosocial factors and pain; higher body mass index was associated with more pain among White but not among Black players. Fatigue and psychosocial factors were more strongly related to pain among Black players relative to White players. Collectively, the substantial social and economic advantages of working as a professional athlete did not seem to erase race-related disparities in pain. We highlight an increased burden of pain among elite Black professional football players and identify race-specific patterns of association between pain and biopsychosocial pain risk factors. These findings illuminate potential future targets of interventions that may serve to reduce persistent disparities in the experience and impact of pain.

Chronic traumatic encephalopathy (CTE) is a brain condition thought to be linked to repeated injuries to the head. In this study, researchers attempted to replicate findings from a landmark study (Stern et al. NEJM, 2019) that used PET, showing increased tau in the brains of former professional football players when compared to controls. Our results call into question the results of that study and whether a specific PET tracer can be used to diagnose or study CTE in living players.

As part of our In-person Assessment Study, a 54-year-old former NFL player was tested after he was previously diagnosed with frontotemporal dementia prior to his participation in the study. A brain MRI examination revealed that he suffers from Normal Pressure Hydrocephalus (NPH). This case highlights the challenges in diagnosing cognitive decline for physicians, and an opportunity to explore treatable causes of cognitive impairment in former athletes.