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Association between Recurrent Concussion and Late-Life Cognitive Impairment in Retired Professional Football Players
Abstract
OBJECTIVE: Cerebral concussion is common in collision sports such as football, yet the chronic neurological effects of recurrent concussion are not well understood. The purpose of our study was to investigate the association between previous head injury and the likelihood of developing mild cognitive impairment (MCI) and Alzheimer's disease in a unique group of retired professional football players with previous head injury exposure. METHODS: A general health questionnaire was completed by 2552 retired professional football players with an average age of 53.8 (±13.4) years and an average professional football playing career of 6.6 (± 3.6) years. A second questionnaire focusing on memory and issues related to MCI was then completed by a subset of 758 retired professional football players (≥50 yr of age). Results on MCI were then cross-tabulated with results from the original health questionnaire for this subset of older retirees. RESULTS: Of the former players, 61% sustained at least one concussion during their professional football career, and 24% sustained three or more concussions. Statistical analysis of the data identified an association between recurrent concussion and clinically diagnosed MCI (χ2 = 7.82, df = 2, P = 0.02) and self-reported significant memory impairments (χ2 = 19.75, df = 2, P = 0.001). Retired players with three or more reported concussions had a fivefold prevalence of MCI diagnosis and a threefold prevalence of reported significant memory problems compared with retirees without a history of concussion. Although there was not an association between recurrent concussion and Alzheimer's disease, we observed an earlier onset of Alzheimer's disease in the retirees than in the general American male population CONCLUSION: Our findings suggest that the onset of dementia-related syndromes may be initiated by repetitive cerebral concussions in professional football players.
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“Our third finding, on the effects of recurrent injuries, is broadly consistent with the emerging literature on the adverse consequences of sports and combat-related neurotrauma [7,9,11–14,46–49].”
In the citing paper
“Epidemiological studies have consistently found higher rates of adverse outcomes in adults who have sustained a TBI when compared to the general population [7–16].”
In the citing paper
“surveys of retired professional football players found that players who reported sustaining three or more concussions were significantly more likely to report cognitive symptoms, including a threefold increase in self-reported significant memory impairment and a fivefold increase in diagnosed mild cognitive impairment [77].”
From The neuropathology of sport (2014) · cites this paper as [77]
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Metadata
- Authors
- Guskiewicz, K. M., Marshall, S. W., Bailes, J., McCrea, M., Cantu, R. C., Randolph, C., & Jordan, B. D.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- ORCID
- Venue
- Neurosurgery
- Published
- 2005-10
- Volume
- 57
- Issue
- 4
- Pages
- 719-726
- ISSN
- 0148-396X (ISSN-L)
- OpenAlex
- W2105910930
- Cited by
- 1,197
- References
- 43
- Citations by year
- 2026: 21 · 2025: 29 · 2024: 29 · 2023: 38 · 2022: 48 · 2021: 71 · 2020: 66 · 2019: 84 · 2018: 75 · 2017: 95 · 2016: 88 · 2015: 100 · 2014: 92 · 2013: 93 · 2012: 70
- FWCI
- 10.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurosurgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- recurrent concussion, mild cognitive impairment, Alzheimer's disease, traumatic brain injury, memory impairment, dementia onset, chronic traumatic encephalopathy, sports-related brain injury
- MeSH terms
- Adult, Age Factors, Aged, Alzheimer Disease, Brain Concussion, Cognition Disorders, Football, Health Surveys, Humans, Male, Middle Aged, Recurrence, Retirement
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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