Estimated age of first exposure to American football and outcome from concussion

Caccese, Jaclyn B.; Houck, Zac; Kaminski, Thomas W.; Clugston, James R.; Bryk, Kelsey; Oldham, Jessie R.; Pasquina, Paul F.; Broglio, Steven P.; McAllister, Thomas W.; Buckley, Thomas A.

doi:10.1212/01.wnl.0000580888.56349.3a

Cited by 3 publications

(16 citation statements)

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“…One limitation of our study was that career duration was based on participant’s self-reported eAFE to collision sports. This approach, though, is consistent with that of previous eAFE studies investigating similar populations, 11-14,25 as well as studies of older/retired athletes. 25,44,47,48 We were also unable to verify that individuals participated in collision sports continuously from the age that they self-reported, but as both institutions were sponsored NCAA Division I intercollegiate athletic programs, it is highly likely that this approach is accurate, as lengthy breaks in participation would be quite unusual.…”

Section: Discussionsupporting

confidence: 89%

“…Therefore, we determined career duration by subtracting the participant's eAFE from his age at the time of testing, as done in the eAFE literature. [11][12][13][14] Despite the difference in career duration metrics between testing sites, the results were not significantly different when each site was analyzed independently. In addition to career duration and/or eAFE, participants had to self-report the number of diagnosed concussions sustained before testing.…”

Section: Career Durationmentioning

confidence: 86%

“…1,44,47,48 At the collegiate level, recent investigations of healthy NCAA student-athletes found no evidence of an association between estimated age of first exposure (eAFE) and worse outcomes on clinical concussion measures, including neurocognitive function, psychological distress, experienced symptoms, or symptom recovery. [11][12][13][14]25 The relationship between eAFE and functional outcomes has been robustly examined in recent years; however, overall collision sport career duration, as opposed to eAFE, has been recently proposed as the primary diagnostic exposure variable for traumatic encephalopathy syndrome. 26 Overall career duration of collision sports participation may provide a more direct measure of the role of RHIs on functional outcomes versus eAFE, which does not account for number of years of participation.…”

mentioning

confidence: 99%

“…26 There is minimal but mixed literature investigating the role of collision sport career duration on long-term outcomes, and the existing studies have largely been conducted on retired or deceased former athletes. 15,36,37,45 No association between earlier eAFE and postural stability has been observed in collegiate athletes 11,13 ; however, the existing investigations used the Balance Error Scoring System, which, despite being commonly used by NCAA athletic trainers, 27 is limited by poor psychometrics and measures postural stability in a quiet stance domain. 7 Conversely, gait is a dynamic postural control task that serves as an element of neurological health.…”

mentioning

confidence: 99%

“…No association between earlier eAFE and postural stability has been observed in collegiate athletes 11,13 ; however, the existing investigations used the Balance Error Scoring System, which, despite being commonly used by NCAA athletic trainers, 27 is limited by poor psychometrics and measures postural stability in a quiet stance domain. 7 Conversely, gait is a dynamic postural control task that serves as an element of neurological health.…”

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confidence: 99%

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Association Between Collision Sport Career Duration and Gait Performance in Male Collegiate Student-Athletes

et al. 2022

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Background: Investigations of estimated age of first exposure to repetitive head impacts from collision and contact sports have shown no associations with neurocognitive or neurobehavioral function at the collegiate level, but the effect of career duration may be a more comprehensive factor. Understanding whether longer career duration influences gait performance would provide insights into potential neurological impairment. Purpose: To examine the relationship between career duration of collision sports and single/dual-task gait performance in collegiate student-athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We recruited 168 male student-athletes from collision sports: football, lacrosse, ice hockey, and wrestling (mean ± SD age, 19.2 ± 1.3 years; height, 184.5 ± 7.2 cm; mass, 94.3 ± 15.9 kg; estimated age of first exposure, 8.6 ± 3.1 years; career duration, 10.6 ± 3.0 years). All participants completed a baseline single- and dual-task gait assessment before the start of their athletic season. Inertial measurement units were used to measure gait speed and stride length. During the dual task, participants were asked to perform working memory cognitive tasks while walking. The dependent variables were single/dual-task gait speed and stride length, cognitive accuracy, and dual-task cost. The relationship between career duration, analyzed as a continuous variable, and the dependent variables was analyzed using a linear regression. Results: There were no significant associations between career duration and single-task gait speed (1.16 ± 0.16 m/s; β = −0.004; P = .35; 95% CI = −0.012 to 0.004; η2 = 0.005) or dual-task gait speed (1.02 ± 0.17 m/s; β = −0.003; P = .57; 95% CI = −0.011 to 0.006; η2 = 0.002). There were also no significant associations between career duration and single/dual-task stride length, cognitive accuracy, or dual-task cost. Conclusion: Career duration among collegiate collision sport athletes was not associated with single- or dual-task gait performance, suggesting that a greater exposure to repetitive head impacts is not detrimental to dynamic postural control at the college level. However, the effects of diminished gait performance over the lifetime remain to be elucidated.

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Section: Discussionsupporting

confidence: 89%

Section: Career Durationmentioning

confidence: 86%

mentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Association Between Collision Sport Career Duration and Gait Performance in Male Collegiate Student-Athletes

et al. 2022

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White matter hyperintensities in former American football players

Alosco

Tripodis

Baucom

et al. 2022

Alzheimer's & Dementia

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Introduction:The presentation, risk factors, and etiologies of white matter hyperintensities (WMH) in people exposed to repetitive head impacts are unknown. We examined the burden and distribution of WMH, and their association with years of play, age of first exposure, and clinical function in former American football players.Methods: A total of 149 former football players and 53 asymptomatic unexposed participants (all men, 45-74 years) completed fluid-attenuated inversion recovery magnetic resonance imaging, neuropsychological testing, and self-report neuropsychiatric measures. Lesion Segmentation Toolbox estimated WMH. Analyses were performed in the total sample and stratified by age 60. Results:In older but not younger participants, former football players had greater total, frontal, temporal, and parietal log-WMH compared to asymptomatic unexposed men. In older but not younger former football players, greater log-WMH was associated with younger age of first exposure to football and worse executive function.Discussion: In older former football players, WMH may have unique presentations, risk factors, and etiologies.

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Age of First Exposure to Collision Sports Does Not Affect Patient Reported Outcomes in Women and Men Community Rugby Players

Hunzinger

Caccese

Costantini

et al. 2021

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose: This study aimed to determine the relationship between age of first exposure (AFE) to repetitive head impacts through contact/collision sports and patient-reported outcomes in community rugby players. Methods: We recruited community rugby players older than 18 yr with at least 1 yr of contact rugby participation to complete an online survey. Participants completed the Brief Symptom Inventory-18 (BSI-18), Short-Form Health Survey 12 (SF-12), and Satisfaction with Life Scale (SWLS) via Qualtrics. We used generalized linear models to examine the association between AFE (continuous) and patient-reported outcomes by sex, while controlling for cumulative years contact/collision sport history, age, and concussion history (yes/no). In addition, we used Mann-Whitney U tests to compare patient-reported outcomes between AFE <12 and AFE ≥12. Results: A total of 1037 rugby players (31.6 ± 11.3 yr (range, 18-74 yr), 59.1% men) participated in this study. Whether analyzed continuously or dichotomously at age 12 yr, younger AFE was not associated with worse patient-reported outcomes for either men or women. Positive concussion history was a significant predictor of worse BSI-18 subscores, SF-12 subscores, and SWLS in women and worse BSI-18 subscores in men. Cumulative contact/collision sport history was a significant predictor of better BSI-18 Depression and SF-12 (Mental Component Summary) subscores in men only. In men and women, older age was a significant predictor of better BSI-18 Depression, Anxiety, and GSI subscores; better SWLS (in men only); and better SF-12 Mental Component Summary, but worse SF-12 (Physical Component Summary). Conclusions: Younger AFE to contact/collision sport is not associated with worse patient-reported outcomes in early adult rugby players. Concussion history was predictive of worse patient-reported outcomes.

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Estimated age of first exposure to American football and outcome from concussion

Cited by 3 publications

References 0 publications

Association Between Collision Sport Career Duration and Gait Performance in Male Collegiate Student-Athletes

Association Between Collision Sport Career Duration and Gait Performance in Male Collegiate Student-Athletes

White matter hyperintensities in former American football players

Age of First Exposure to Collision Sports Does Not Affect Patient Reported Outcomes in Women and Men Community Rugby Players

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