Mortality Among Professional American-Style Football Players and Professional American Baseball Players

Nguyen, Vy T.; Zafonte, Ross; Chen, Jarvis T.; Kponee-Shovein, Kalé; Paganoni, Sabrina; Pascual‐Leone, Álvaro; Speizer, Frank E.; Baggish, Aaron L.; Taylor, Herman A.; Nadler, Lee M.; Courtney, Theodore K.; Connor, Ann; Weisskopf, Marc G.

doi:10.1001/jamanetworkopen.2019.4223

Cited by 76 publications

(122 citation statements)

References 50 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…Finally, evidence from the external comparison groups provide grounds for assessing the overall effect of sport participation, including all pros and cons, and it is expected to be associated with better health due to a selection effect, and also partially to the physical activity, and general healthy habits that athletes display in comparison with any non-athlete group (healthy cohort effect), as previously found 43 44. Nonetheless, this selection effect might be heterogeneous across sports,45 and it might be mitigated by the emergence of some lifestyle choices after retirement, as demonstrated for increased body mass index 48. However, overall, an inverse associations between participating in sports and general health (specifically for cardiovascular diseases and cancer outcomes) is expected, including the overall risk of dementia when athletes are compared with the general population.…”

Section: Discussionmentioning

confidence: 88%

“…However, these differences are very unlikely to be exclusively due to concussion, they could be confounded by any other characteristics of the athletes included (eg, use of licit/illicit drugs, alcohol intake, lifestyle and psychosocial risk factors, etc). Moreover, one would expect to see among the former athletes a healthy cohort effect with decreased prevalence of cardiovascular disease and cancer risk factors,43 44 although to what extent this is consistent across generations and across sport disciplines, is to date unclear 45. On the other hand, studies investigating cognitive functions with neuropsychological batteries, in most cases find subtle, although statistically significant, differences which are not easy to interpret in terms of clinical significance 28 29 31 33 42.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Concussion and long-term cognitive impairment among professional or elite sport-persons: a systematic review

Gallo¹,

Motley

Kemp

et al. 2020

J Neurol Neurosurg Psychiatry

View full text Add to dashboard Cite

IntroductionUnderstanding whether concussion in sport is associated with worsening cognitive function in later life will likely have immediate repercussion on sports concussion prevention and management policy and sporting rules and regulations. This systematic review aims to summarise the evidence on the association between concussion sustained by professional/elite athletes and long-term cognitive impairment.MethodsEmbase, PubMed and Web of Science were used to search for eligible studies. Studies including professional/elite athletes from any sport were considered. Three comparison groups were considered: internal comparison (concussed vs non-concussed athletes within the same sample); between-sport comparison (contact sport athletes vs non-contact sports ones); external comparison (athletes vs samples of the general population or population norms).Results14 studies were included (rugby, American football, ice hockey players, boxers and marital art fighters). The general quality of the evidence was poor. The overall evidence, weighted for type of comparison and study quality, points towards an association between sustaining a sport-related concussion and poorer cognitive function later in life in rugby, American football and boxing, although it is unclear to what extent this is clinically relevant. Data on ice hockey and martial arts were too sparse to allow conclusions to be drawn.ConclusionHigh-quality, appropriately designed and powered epidemiological studies are urgently needed to assess the association between sustaining a sport-related concussion and cognitive impairment later in life. Particular emphasis should be put on the clinical translational value of findings.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Concussion and long-term cognitive impairment among professional or elite sport-persons: a systematic review

Gallo¹,

Motley

Kemp

et al. 2020

J Neurol Neurosurg Psychiatry

View full text Add to dashboard Cite

show abstract

“…Research suggests EPA and DHA may reduce cardiovascular risk factors such as dyslipidemia and high blood pressure [58][59][60] and even sudden death related to cardiac causes [61][62][63][64][65], which are applicable to a wide variety of athletes. This will continue to be of particular interest for higher mass athletes (such as linemen in American football) observed to be at higher risk of cardiovascular disease and metabolic syndrome [61,66,67]. Given this concern, in combination with the associated health functions of ω-3 FA related to both athlete performance and well-being [2, 3, 8-13, 15-24, 26], a focus on improved O3i is warranted.…”

Section: Plos Onementioning

confidence: 99%

Dietary and Biological Assessment of the Omega-3 Status of Collegiate Athletes: A Cross-Sectional Analysis

et al. 2020

View full text Add to dashboard Cite

Omega-3 fatty acids (ω-3 FA) are associated with cardiovascular health, brain function, reduction of inflammation, and several other physiological roles of importance to competitive athletes. The ω-3 FA status of National Collegiate Athletic Association (NCAA) Division I athletes has not been well-described. The purpose of this study was to evaluate the ω-3 FA status of NCAA Division I athletes using dietary and biological assessment methodology. Athletes from nine NCAA Division I institutions from throughout the U.S. (n = 1,528, 51% male, 34 sports represented, 19.9 ± 1.4 years of age) completed a food frequency questionnaire (FFQ) to assess ω-3 FA from diet and supplements. Omega-3 Index (O3i) was evaluated in a subset of these participants (n = 298, 55% male, 21 sports represented, 20.0 ± 1.3 years of age) using dried blood spot sampling. Only 6% (n = 93) of athletes achieved the Academy of Nutrition & Dietetics' recommendation to consume 500 mg DHA+EPA per day. Use of ω-3 FA supplements was reported by 15% (n = 229) of participants. O3i was 4.33 ± 0.81%, with no participants meeting the O3i benchmark of 8% associated with the lowest risk of cardiovascular disease. Every additional weekly serving of fish or seafood was associated with an absolute O3i increase of 0.27%. Overall, sub-optimal ω-3 FA status was observed among a large, geographically diverse group of male and female NCAA Division I athletes. These findings may inform interventions aimed at improving ω-3 FA status of collegiate athletes. Further research on athlete-specific ω-3 FA requirements is needed.

show abstract

“…While society considers intervening, we urge continued research, especially in the following areas: (1) looking for natural experiments such as the studies of improved lung function and reduced mortality during short-duration improvements in air quality during Olympic Games and the like, 64 where we might see rapid changes in some marker of outcome during perturbations in exposure; (2) mounting epidemiological studies where the unexposed group comprises athletes without RHI exposure, thereby minimizing the healthy worker effect i (refer to as this article was in press, Nguyen et al 65 reported on just such a study: they compared 3415 former NFL players born between 1915 and 1965 with 2708 former Major League Baseball (MLB) players born in the same time period. They documented a statistically-significant three-fold ratio (NFL:MLB) of neurodegenerative diseases as the underlying or contributing cause of death across the two athlete groups); (3) trying to develop the most biologically meaningful indices of peak and of cumulative exposure to forces that cause CTE; and (4) further validating the supposition that CTE is rare in subpopulations without RHI.…”

Section: From Analysis To Actionmentioning

confidence: 99%

A Decision-Analytic Approach to Addressing the Evidence About Football and Chronic Traumatic Encephalopathy

Brand

Finkel

2019

Semin Neurol

View full text Add to dashboard Cite

Doubts can be raised about almost any assertion that a particular exposure can lead to an increase in a given adverse health effect. Even some of the most well-accepted causal associations in public health, such as that linking cigarette smoking to increased lung cancer risk, have intriguing research questions remaining to be answered. The inquiry whether an exposure causes a disease is never wholly a yes/no question but ought to follow from an appraisal of the weight of evidence supporting the positive conclusion in light of any coherent theories casting doubt on this evidence and the data supporting these. More importantly, such an appraisal cannot be made sensibly without considering the relative consequences to public health and economic welfare of specific actions based on unwarranted credulity (false positives) versus unwarranted skepticism (false negatives). Here we appraise the weight of evidence for the premise that repeated head impacts (RHIs) in professional football can increase the incidence of chronic traumatic encephalopathy (CTE) and, in turn, cause a variety of cognitive and behavioral symptoms. We first dismiss four logical fallacies that should not affect the appraisal of the weight of evidence. We then examine four alternative hypotheses in which RHI is not associated with CTE or symptoms (or both), and we conclude that the chances are small that the RHI→ CTE→ symptoms link is coincidental or artifactual. In particular, we observe that there are many specific interventions for which, even under a skeptical appraisal of the weight of evidence, the costs of a false positive are smaller than the false negative costs of refusing to intervene.

show abstract

Mortality Among Professional American-Style Football Players and Professional American Baseball Players

Cited by 76 publications

References 50 publications

Concussion and long-term cognitive impairment among professional or elite sport-persons: a systematic review

Concussion and long-term cognitive impairment among professional or elite sport-persons: a systematic review

Dietary and Biological Assessment of the Omega-3 Status of Collegiate Athletes: A Cross-Sectional Analysis

A Decision-Analytic Approach to Addressing the Evidence About Football and Chronic Traumatic Encephalopathy

Contact Info

Product

Resources

About