Word-reading ability as a “hold test” in cognitively normal young adults with history of concussion and repetitive head impact exposure: A CARE Consortium Study

Asken, Breton M; Houck, Zachary M; Clugston, James R.; Larrabee, Glenn J.; Broglio, Steven P.; McCrea, Michael; McAllister, Thomas W.; Bauer, Russell M.

doi:10.1080/13854046.2019.1680735

Cited by 5 publications

(9 citation statements)

References 41 publications

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“…Four ( 9 – 11 , 20 ) of the nine studies reported no association between age of first exposure to football and later-in-life brain health problems. Moreover, in all studies of current high school and collegiate athletes, earlier age of first exposure to contact and collision sports has not been associated with worse neurocognitive functioning, subjectively-experienced symptoms, or postural control during preseason baseline testing ( 12 – 16 , 18 , 19 ), or worse clinical outcome following concussion ( 17 ). Considering the literature more broadly, separate from the issue of age of first exposure to football, results from 7 studies ( 33 – 38 ) 2 have observed that men who played high school football are not at increased risk for later-in-life neurodegenerative disease ( 36 , 37 ), and they do not report greater mental health problems in their 20s ( 33 , 34 ), during middle age 2 , or during older adulthood ( 35 , 38 ).…”

Section: Discussionmentioning

confidence: 96%

“…With time, other research groups have independently conducted 11 studies using diverse samples and methodologies, with none observing an association between earlier age of first exposure to football (or other contact and collision sports) and worse clinical or brain imaging outcomes (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). In current high school and collegiate athletes, age of first exposure was not associated with objectively measured neurocognitive functioning, subjectively-experienced symptoms, or postural control across seven highly-powered, observational studies (12-16, 18, 19).…”

Section: Introductionmentioning

confidence: 99%

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Age of First Exposure to Football Is Not Associated With Later-in-Life Cognitive or Mental Health Problems

et al. 2021

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Background: The purpose of this study was to determine if earlier age of first exposure to football is associated with worse brain health in middle-aged and older adult men who played high school football.Methods: Men from the United States, aged 35 and older, who reported playing high school football, completed a customized, online health survey via the Amazon Mechanical Turk (mTurk) platform. Survey items included physical, psychological, and cognitive symptoms over the past week and over the past year, sports participation history (including age of first exposure to football), medical history, and concussion history. Participants also completed the Patient Health Questionnaire-8 (PHQ-8) and the British Columbia Post-Concussion Symptom Inventory (BC-PSI).Results: There were 186 men (age M = 51.78, SD = 10.93) who participated in high school football, and 87 (46.8%) reported football participation starting before the age of 12 and 99 (53.2%) reported football participation at or after the age of 12. Those who started playing football at an earlier age reported a greater number of lifetime concussions (M = 1.95, SD = 1.79) compared to those who started playing at age 12 or later (M = 1.28, SD = 1.52; U = 3,257.5, p = 0.003). A similar proportion of men who played football before vs. after the age of 12 reported a lifetime history of being prescribed medications for depression, anxiety, chronic pain, headaches, or memory problems. When comparing men who played football before vs. after the age of 12, the groups did not differ significantly in their ratings of depression, anger, anxiety, headaches, migraines, neck or back pain, chronic pain, concentration problems, or memory problems over the past week or the past year. The two groups did not differ significantly in their ratings of current symptoms of depression (PHQ-8; U = 4,187.0, p = 0.74) or post-concussion-like symptoms (BC-PSI; U = 3,944.0, p = 0.53). Furthermore, there were no statistically significant correlations between the age of first exposure to football, as a continuous variable, and PHQ-8 or BC-PSI scores.Conclusion: This study adds to a rapidly growing body of literature suggesting that earlier age of first exposure to football is not associated with later-in-life brain health.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Age of First Exposure to Football Is Not Associated With Later-in-Life Cognitive or Mental Health Problems

et al. 2021

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“…Additionally, the authors did not cite any studies to support this opinion that playing football before age 12 causes learning disabilities or somehow interferes with a person's lifelong proficiency in single word reading, and we are not aware of any studies that support these assertions. In contrast, a recent study suggested that neurotrauma exposure variables explained <1% of the variance on a word reading test, whereas sociodemographic and academic aptitude variables explained >20% of the variance in a sample of 6,598 collegiate student-athletes ( 111 ). Thus, a more parsimonious and logical explanation is that differences in rates of learning disabilities, and lower reading scores, were not caused by playing the sport at an earlier age but rather reflect a longstanding, lifelong difference between both (small) samples of former NFL players.…”

Section: Origin Of the Theorymentioning

confidence: 91%

“…For example, several large-scale studies have shown that having a neurodevelopmental problem, such as ADHD ( 109 , 110 ), learning disability ( 109 , 110 ), or significant academic problems ( 107 , 108 ), was associated with lower scores on cognitive testing and greater self-reported physical, cognitive, and emotional symptoms. Lower SES and other sociodemographic disparities were also associated with worse performance on cognitive testing in student athletes ( 90 , 111 , 125 ). These studies are not without limitations, however.…”

Section: Studies With Current Athletesmentioning

confidence: 99%

“…These studies are not without limitations, however. Notably, most large cohorts were recruited through a single study, the National Collegiate Athletic Association (NCAA)-US Department of Defense (DoD) Grand Alliance Concussion Assessment, Research and Education (CARE) Consortium Study ( 87 – 90 , 111 , 123 ), and outcome measures were selected based on those typically included in sport-related concussion baseline assessments, which may not be as sensitive for more subtle effects of early exposure to repetitive head impacts. Furthermore, findings only inform short- to medium-term effects in current athletes who may have sufficient cognitive reserve to mask potential consequences of earlier AFE to repetitive neurotrauma.…”

Section: Studies With Current Athletesmentioning

confidence: 99%

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Age of First Exposure to Contact and Collision Sports and Later in Life Brain Health: A Narrative Review

Büttner

Caccese

2021

Front. Neurol.

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A controversial theory proposes that playing tackle football before the age of 12 causes later in life brain health problems. This theory arose from a small study of 42 retired National Football League (NFL) players, which reported that those who started playing tackle football at a younger age performed worse on selected neuropsychological tests and a word reading test. The authors concluded that these differences were likely due to greater exposure to repetitive neurotrauma during a developmentally sensitive maturational period in their lives. Several subsequent studies of current high school and collegiate contact/collision sports athletes, and former high school, collegiate, and professional tackle football players have not replicated these findings. This narrative review aims to (i) discuss the fundamental concepts, issues, and controversies surrounding existing research on age of first exposure (AFE) to contact/collision sport, and (ii) provide a balanced interpretation, including risk of bias assessment findings, of this body of evidence. Among 21 studies, 11 studies examined former athletes, 8 studies examined current athletes, and 2 studies examined both former and current athletes. Although the literature on whether younger AFE to tackle football is associated with later in life cognitive, neurobehavioral, or mental health problems in former NFL players is mixed, the largest study of retired NFL players (N = 3,506) suggested there was not a significant association between earlier AFE to organized tackle football and worse subjectively experienced cognitive functioning, depression, or anxiety. Furthermore, no published studies of current athletes show a significant association between playing tackle football (or other contact/collision sports) before the age of 12 and cognitive, neurobehavioral, or mental health problems. It is important to note that all studies were judged to be at high overall risk of bias, indicating that more methodologically rigorous research is needed to understand whether there is an association between AFE to contact/collision sports and later in life brain health. The accumulated research to date suggests that earlier AFE to contact/collision sports is not associated with worse cognitive functioning or mental health in (i) current high school athletes, (ii) current collegiate athletes, or (iii) middle-aged men who played high school football. The literature on former NFL players is mixed and does not, at present, clearly support the theory that exposure to tackle football before age 12 is associated with later in life cognitive impairment or mental health problems.

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Predictors of poor reading performance in student-athletes following sport-related concussion

Sherry

Trbovich

Holland

et al. 2021

Applied Neuropsychology: Child

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Word-reading ability as a “hold test” in cognitively normal young adults with history of concussion and repetitive head impact exposure: A CARE Consortium Study

Cited by 5 publications

References 41 publications

Age of First Exposure to Football Is Not Associated With Later-in-Life Cognitive or Mental Health Problems

Age of First Exposure to Football Is Not Associated With Later-in-Life Cognitive or Mental Health Problems

Age of First Exposure to Contact and Collision Sports and Later in Life Brain Health: A Narrative Review

Predictors of poor reading performance in student-athletes following sport-related concussion

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