Tolerable Risks? Physicians and Youth Tackle Football

Bachynski, Kathleen

doi:10.1056/nejmp1513993

Cited by 26 publications

(21 citation statements)

References 2 publications

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“…There has been growing concern about the long-term health consequences of playing American-style tackle football, driven in large part by high-profile suicides and case reports of chronic traumatic encephalopathy (CTE) among former players [1], increased risks or neurodegenerative disease [2], and associations between concussion history and cognitive impairment and depression later in life [3][4][5]. These concerns have led some medical professionals [6][7][8] and policy makers [9] to propose limiting or banning youth tackle football. Careful estimation of the short-and long-term consequences of playing youth and adolescent football can help physicians better advise families weighing the benefits and risks of football participation [10].…”

Section: Introductionmentioning

confidence: 99%

The association between adolescent football participation and early adulthood depression

et al. 2020

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Concerned about potentially increased risk of neurodegenerative disease, several health professionals and policy makers have proposed limiting or banning youth participation in American-style tackle football. Given the large affected population (over 1 million boys play high school football annually), careful estimation of the long-term health effects of playing football is necessary for developing effective public health policy. Unfortunately, existing attempts to estimate these effects tend not to generalize to current participants because they either studied a much older cohort or, more seriously, failed to account for potential confounding. We leverage data from a nationally representative cohort of American men who were in grades 7-12 in the 1994-95 school year to estimate the effect of playing football in adolescent on depression in early adulthood. We control for several potential confounders related to subjects' health, behavior, educational experience, family background, and family health history through matching and regression adjustment. We found no evidence of even a small harmful effect of football participation on scores on a version of the Center for Epidemiological Studies Depression scale (CES-D) nor did we find evidence of adverse associations with several secondary outcomes including anxiety disorder diagnosis or alcohol dependence in early adulthood. For men who were in grades 7-12 in the 1994-95 school year, participating or intending to participate in school football does not appear to be a major risk factor for early adulthood depression.

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Section: Introductionmentioning

confidence: 99%

The association between adolescent football participation and early adulthood depression

et al. 2020

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“…11,12,16 Additionally, early exposure to tackle football has been linked with earlier onset of chronic traumatic encephalopathy, leading some to question the safety of the youth game. 1,2,27 However, others argue that participation in contact sports, concussion, the development of chronic traumatic encephalopathy, and downstream adverse effects have been conflated, although there is little evidence of a causal link among them. 8,25…”

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confidence: 99%

Association of Adolescent Sport Participation With Cognition and Depressive Symptoms in Early Adulthood

Bohr

Boardman

McQueen

2019

Orthopaedic Journal of Sports Medicine

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Background: Recent studies have associated sport-related concussion with depression and impaired cognitive ability later in life in former professional football players. However, population studies with two 1950s-era cohorts did not find an association between high school football participation and impaired cognition or depressive symptoms in late adulthood. Purpose/Hypothesis: This study assessed whether actual/intended participation in contact sports during adolescence had an adverse effect on participants’ cognition or depressive symptoms in early adulthood. We hypothesized that there would not be an association. Study Design: Cohort study; Level of evidence, 2. Methods: This study used a subsample (n = 10,951) from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally (United States) representative prospective cohort study following participants through 4 waves of data collection from 1994 through 2008. Participants were categorized as actual/intended participation in no sports, noncontact sports only, and contact sports. We constructed 6 multivariate and logistic regression models predicting word recall, number recall, modified Center for Epidemiologic Studies Depression Scale, depression diagnosis, suicide ideation, and suicide attempts at wave IV as a function of sport participation during wave I. Sport participation was treated as a factor with the referent category noncontact sports. This analysis was repeated on a males-only sample (n = 5008). In the males-only analysis, participants were classified as actual/intended participation in no sports, noncontact sports, contact sports other than American football, and American football. The referent category remained noncontact sports. Results: Intention to participate in contact sports was not significantly associated with any of the outcomes in the full-sample analysis. Intention to participate in football was significantly associated with a reduced odds of depression diagnosis in adulthood (odds ratio, 0.70; P = .02) when compared with noncontact sports participation in the males-only sample. Football was not significantly associated with impaired cognitive ability, increased depressive symptoms, or increased suicide ideation. Conclusion: Actual/intended participation in contact sports during adolescence did not adversely affect Add Health participants’ cognition or depressive symptoms in young adulthood.

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“…More than 1 million high school students played American-style tackle football in 2014, but many medical professionals have recently begun questioning the safety of the sport (Bachynski, 2016;Pfister et al, 2016) or called for its outright ban (Miles and Prasad, 2016). Concern over the long-term safety of the sport have been driven partially by studies like Lehman et al (2012), which found an increased risk of neurodegenerative disease and Guskiewicz et al (2005Guskiewicz et al ( , 2007 and Hart Jr et al (2013), which highlighted associations between concussion history and later-life cognitive impairment and depression.…”

Section: Full Multivariate Analysis Of the Football Safety Datamentioning

confidence: 99%

Simultaneous Variable and Covariance Selection With the Multivariate Spike-and-Slab LASSO

Deshpande

Ročková

George

2019

Journal of Computational and Graphical Statistics

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We propose a Bayesian procedure for simultaneous variable and covariance selection using continuous spike-and-slab priors in multivariate linear regression models where q possibly correlated responses are regressed onto p predictors. Rather than relying on a stochastic search through the high-dimensional model space, we develop an ECM algorithm similar to the EMVS procedure of Ročková & George (2014) targeting modal estimates of the matrix of regression coefficients and residual precision matrix. Varying the scale of the continuous spike densities facilitates dynamic posterior exploration and allows us to filter out negligible regression coefficients and partial covariances gradually. Our method is seen to substantially outperform regularization competitors on simulated data. We demonstrate our method with a re-examination of data from a recent observational study of the effect of playing high school football on several later-life cognition, psychological, and socio-economic outcomes.

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Tolerable Risks? Physicians and Youth Tackle Football

Cited by 26 publications

References 2 publications

The association between adolescent football participation and early adulthood depression

The association between adolescent football participation and early adulthood depression

Association of Adolescent Sport Participation With Cognition and Depressive Symptoms in Early Adulthood

Simultaneous Variable and Covariance Selection With the Multivariate Spike-and-Slab LASSO

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