Neuropsychological Functioning in Aging National Football League Retirees

Concussive and sub-concussive head impacts sustained over a National Football League (NFL) career have been proposed to increase risk for later cognitive impairment. However, research is generally limited on the neuropsychological functioning among NFL retirees, and no studies to date have investigated the cognitive performance of NFL retirees over time. Study One was a critical review of research on neuropsychological functioning among NFL retirees. Findings were mixed, but studies suggested some NFL retirees have lower verbal memory, confrontation naming, and executive functioning abilities compared to control groups. Investigations of dose-response relationships between cognition and head-injury exposure also generated mixed findings which may be related to small samples, sampling bias, small effect sizes, and the measurement of different head-injury exposure variables. Study Two was a prospective cohort design investigating neuropsychological functioning and head-injury exposure in NFL retirees aged 50 and up. Retirees underwent baseline (N = 53) and follow-up (N = 29) comprehensive neuropsychological evaluations. Cognitively normal retirees (n = 26) were age, education, and IQ-matched to healthy controls (n = 26). Retirees diagnosed with MCI or dementia (n = 27) were matched as closely as possible to a clinical sample of patients with MCI and dementia by age, education, and diagnosis (n = 22). Independent samples t-tests and repeated measures ANCOVAs were used to evaluate neuropsychological scores between groups. Pearson correlations, partial correlations, and quadratic regressions were used to examine relationships between head-injury exposure and neuropsychological scores. Head-injury exposure variables included concussions, number of concussions with loss of consciousness, years playing professionally, games played, games started, and age beginning tackle football. Overall, NFL retirees did not significantly differ on the majority of measures at baseline or on any measures over time compared to their respective control groups. Furthermore, the vast majority of neuropsychological scores were not significantly related to head-injury exposure, regardless of cognitive diagnosis. In totality, findings suggest that NFL retirees do not have lower cognitive functioning compare to non-athlete controls later in life, and that head-injury exposure obtained over an NFL career is not related to cognitive functioning later-in-life.