Multi-modality human phenotyping to examine subjective and objective health afflictions in former professional American-style football players: The In-Person Assessment (IPA) protocol

Abstract

Background Participation in American-style football (ASF), one of the most popular sports worldwide, has been associated with adverse health outcomes. However, prior clinical studies of former ASF players have been limited by reliance on subjective self-reported data, inadequate sample size, or focus on a single disease process in isolation. Objective To determine the burden of objective multi-system pathology and its relationship with subjective health complaints among former professional ASF players. Methods The In-Person Assessment is a case-control, multi-day, deep human phenotyping protocol designed to characterize and quantify pathology among former professional ASF players. Participants, recruited from an on-going large-scale longitudinal cohort study, will include 120 men who report either no health conditions, a single health condition, or multiple health conditions across the key domains of cardiometabolic disease, disordered sleep, chronic pain, and cognitive impairment. Data will be collected from validated questionnaires, structured interviews, physical examinations, multi-modality imaging, and functional assessments over a 3-day study period. A pilot study was conducted to assess feasibility and to obtain participant feedback which was used to shape the final protocol. Results This study provides a comprehensive assessment of objective multi-system pathology and its relationship with subjective health complaints among former professional ASF players. Conclusion The study will determine whether subjective health complaints among former professional ASF players are explained by objective explanatory pathology and will provide novel opportunities to examine the interrelatedness of co-morbidities. It is anticipated that this protocol will be applicable to other clinical and occupational populations.

Tau Positron Emission Tomography and Neurocognitive Function Among Former Professional American-Style Football Players

“…The Football Players Health Study (FPHS) at Harvard University 12 recruited 31 former ASF players between the ages of 33 and 60 who: (1) contracted with professional ASF leagues after 1960, the year hard plastic helmets were adopted 13 ; (2) completed the FPHS Health and Wellness survey between the ages of 29 and 55 years; and (3) had previously self-reported a diagnosis of cardiometabolic, neurocognitive, chronic pain, and/or sleep disorder or as unafflicted by any of those conditions. 14 …”

A Case Report of Reversible Cognitive Decline in a Former Professional American-Style Football Player: Findings from the Football Players Health Study In-Person Assessments

“…The Football Players Health Study (FPHS) at Harvard is an ongoing study that aims to characterize the long-term health of former National Football League (NFL) players (13). Some of the study’s participants, ranging in age from 24 to 60 years, took part in “in-person assessments,” in which multi-modality cardiovascular, neurocognitive, endocrinologic, sleep, and chronic pain assessments were performed over the course of a 3-d study visit (14). Prior to each visit, participants completed an initial telephone screening, in which a cognitive assessment was performed using the Telephone-Montreal Cognitive Assessment (T-MoCA-22) (15) and a detailed medical history was taken.…”

“…At completion of the study, each participant attended a structured exit interview with a study physician and nurse, and received a printed report detailing clinically actionable findings. For a more detailed report of the methodology of this study, including all of the assessments conducted, please refer to the published In-Person Assessments protocol (14).…”