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Career Duration and Later-Life Health Conditions Among Former Professional American-Style Football Players

Authors: Grashow, Rachel et al.
Published in: Occupational and Environmental Medicine

October 18, 2024

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Summary:

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.

Perceived Chronic Traumatic Encephalopathy and Suicidality in Former Professional Football Players

Authors: Grashow, Rachel et al.
Published in: JAMA Neurology

September 23, 2024

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Summary:

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.

Posttraumatic Osteoarthritis after Athletic Knee Injury: A Narrative Review of Diagnostic Imaging Strategies

Authors: Fogarty, Alexandra E. et al.
Published in: PM&R

July 31, 2024

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Summary:

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.

Age of First Exposure Does Not Relate to Post-Career Health in Former NFL Players

Authors: Douglas, Terry P. et al.
Published in: Sports Medicine

June 26, 2024

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Summary:

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.

Concussion Burden and Later-Life Cardiovascular Risk Factors in Former Professional American-Style Football Players

Authors: Can, Ozan Tan et al.
Published in: Annals of Clinical and Translational Neurology

May 29, 2024

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Summary:

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.

Interaction of Medical Conditions and Football Exposures Associated with Premortem Chronic Traumatic Encephalopathy Diagnosis in Former Professional American Football Players

Authors: Eagle, Shawn R. et al.
Published in: Sports Medicine

October 6, 2023

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Summary:

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.

Interaction of Medical Conditions and Football Exposures Associated with Premortem Chronic Traumatic Encephalopathy Diagnosis in Former Professional American Football Players

Authors: Eagle, Shawn R. et al.
Published in: Sports Medicine

October 6, 2023

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Summary:

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.

Long-Term Risk of Cardiovascular Disease After Traumatic Brain Injury: Screening and Prevention

Authors: Izzy, Saef et al.
Published in: The Lancet Neurology

October 2, 2023

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Summary:

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.

Long-Term Risk of Cardiovascular Disease after Traumatic Brain Injury: Screening and Prevention

Authors: Izzy, Saef et al.
Published in: The Lancet Neurology

October 1, 2023

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Summary:

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.

The Paradox of Integration: Racial Composition of NFL Positions from 1960 to 2020

Authors: Marquez-Velarde, Guadalupe et al.
Published in: Sociology of Race and Ethnicity

July 10, 2023

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Summary:

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.