Background

Potential links between a history of sport-related concussions and later-life neurobiological and psychological brain health have been studied in former collision-sport athletes. However, empirical studies of how former athletes perceive the future of their brain health as a result of these injuries are missing.

Objectives

We aimed to (1) identify the extent to which former National Football League players currently have concerns about their long-term psychological and cognitive functioning as a result of concussions sustained while playing football; (2) examine whether current concerns are different than concerns they had while playing football; (3) examine the relationship between current brain health concerns and self-reported concussion history (SR-CHx); and (4) explore other important factors associated with these concerns.

Methods

In this cross-sectional study, former National Football League players with a SR-CHx of one or more concussions (n = 1514; aged mean [standard deviation] = 52.3 [15.7] years) completed a general health questionnaire. Participants reported their lifetime concussion history, as well as both their current concerns and concerns while playing football (i.e., retrospective concerns) regarding the long-term effects of concussions on their memory, thinking skills, and risk of developing chronic traumatic encephalopathy. Current and retrospective concerns were self-reported on a five-point Likert scale. Four concussion history categories were created based on SR-CHx: 1–2 (n = 309); 3–5 (n = 413); 6–9 (n = 356); and 10 + (n = 436) lifetime concussions. Proportions of participants reporting each level of current and retrospective concerns were examined to identify whether concerns presently exist in these former players, and whether their current concerns are different than retrospective concerns. Next, we explored associations between current concerns and SR-CHx.

Results

More than one-third of participants reported being currently “extremely concerned” about memory problems (36.9%), thinking skills (37.8%), and developing chronic traumatic encephalopathy (39.5%). In contrast, when asked about concerns while playing, most reported being “not at all concerned” regarding memory = 61.2%, thinking skills = 56.1%, and developing chronic traumatic encephalopathy = 71.2%. Of those who retrospectively endorsed being “not at all” or “slightly” concerned regarding memory (n = 1159/1514), thinking skills (n = 1080/1514), and developing chronic traumatic encephalopathy (n = 1219/1514), approximately half reported being currently “moderately” or “extremely” concerned about those same issues (n = 586/1159; n = 534/1080; n = 619/1219, respectively). Current concerns regarding memory (χ²₁₆ = 316.61; p < 0.001; V = 0.264), thinking skills (χ²₁₆ = 333.17; p < 0.001; V = 0.271), and developing chronic traumatic encephalopathy (χ²₁₆ = 280.85; p < 0.001; V = 0.249) were significantly related to SR-CHx, with more concussions being associated with greater current concerns.

Conclusions

Former National Football League players reported significant concerns regarding the potential effects of their prior concussions on long-term brain health, and these concerns are more prevalent now than when they were playing football. Cognitive and mental health concerns are readily identifiable targets for clinical intervention. Clinicians working with former players may wish to explore the extent to which individual players experience these concerns, the nature and depth of these concerns, and the impact of these concerns on the player’s functioning and well-being.

中文翻译：

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关于运动相关脑震荡对前 NFL 球员长期大脑健康影响的主观担忧：一项 NFL-LONG 研究

背景

已经在前碰撞运动运动员中研究了运动相关脑震荡史与晚年神经生物学和心理大脑健康之间的潜在联系。然而，缺乏关于前运动员如何看待这些受伤导致的大脑健康未来的实证研究。

目标

我们的目标是 (1) 确定前美国国家橄榄球联盟球员目前对其长期心理和认知功能的担忧程度，因为他们在踢足球时持续脑震荡；(2) 检查当前的担忧是否与他们在踢足球时的担忧不同；(3) 检查当前大脑健康问题与自我报告的脑震荡史 (SR-CHx) 之间的关系；(4) 探索与这些问题相关的其他重要因素。

方法

在这项横断面研究中，SR-CHx 有一次或多次脑震荡（n  = 1514；平均年龄 [标准差] = 52.3 [15.7] 岁）的前国家橄榄球联盟球员完成了一份一般健康问卷。参与者报告了他们一生的脑震荡史，以及他们目前的担忧和踢足球时的担忧（即回顾性担忧），即脑震荡对他们的记忆力、思维能力和发展为慢性创伤性脑病的风险的长期影响。当前和回顾性问题以李克特五点量表自我报告。基于 SR-CHx 创建了四个脑震荡历史类别：1-2（n  = 309）；3–5 ( n  = 413); 6–9 ( n  = 356); 和 10 + ( n = 436) 终生脑震荡。检查报告每个级别当前和回顾性问题的参与者的比例，以确定这些前参与者目前是否存在问题，以及他们当前的问题是否与回顾性问题不同。接下来，我们探讨了当前关注点与 SR-CHx 之间的关联。

结果

超过三分之一的参与者报告说目前“非常担心”记忆问题（36.9%）、思维能力（37.8%）和慢性创伤性脑病（39.5%）。相比之下，当被问及玩耍时的担忧时，大多数人表示“完全不关心”记忆 = 61.2%，思维能力 = 56.1%，发展为慢性创伤性脑病 = 71.2%。在那些回顾性地认为“完全不”或“稍微”关注记忆（n  = 1159/1514）、思维能力（n  = 1080/1514）和发展为慢性创伤性脑病（n  = 1219/1514）的人中，大约一半报告说目前“适度”或“极度”关注这些相同的问题（n  = 586/1159；n  = 534/1080；n  = 619/1219，分别）。目前对记忆力（χ ² ₁₆  = 316.61；p  < 0.001；V  = 0.264）、思维能力（χ ² ₁₆  = 333.17；p  < 0.001；V  = 0.271）和发展为慢性创伤性脑病（χ ² ₁₆  = 280.85；p  < 0.001；V  = 0.249）与 SR-CHx 显着相关，更多的脑震荡与更大的当前问题相关。

结论

前美国国家橄榄球联盟球员报告了他们先前的脑震荡对长期大脑健康的潜在影响的重大担忧，这些担忧现在比他们踢足球时更为普遍。认知和心理健康问题是临床干预的容易识别的目标。与前球员一起工作的临床医生可能希望探索个别球员遇到这些问题的程度、这些问题的性质和深度，以及这些问题对球员功能和健康的影响。