Mild Cognitive Impairment and Dementia Reported by Former Professional Football Players over 50 yr of Age: An NFL-LONG Study

• Published in: Medicine and science in sports and exercise 2022-03, Vol.54 (3), p.424-431
• Main Authors: WALTON, SAMUEL R., BRETT, BENJAMIN L., CHANDRAN, AVINASH, DEFREESE, J. D., MANNIX, REBEKAH, ECHEMENDIA, RUBEN J., MEEHAN, WILLIAM P., MCCREA, MICHAEL, GUSKIEWICZ, KEVIN M., KERR, ZACHARY Y.
• Format: Article
• Language: English
• Subjects: Aged; Athletic Injuries - complications; Brain Concussion - complications; Cognitive Dysfunction - epidemiology; Dementia - epidemiology; Football - injuries; Humans; Male; Middle Aged; Prevalence; Retirement; Surveys and Questionnaires; United States - epidemiology
• ISSN: 0195-9131; 1530-0315
• DOI: 10.1249/MSS.0000000000002802

This study aimed to estimate prevalence of mild cognitive impairment (MCI) and dementia diagnoses in former National Football League (NFL) players ≥50 yr old and examine the relationships among these diagnoses and an array of predictors of long-term brain health. A cross section of former NFL players (n = 922; mean ± SD age, 64.8 ± 8.9 yr) completed a questionnaire. Prevalence of self-reported medical diagnoses of MCI and dementia was reported alongside U.S. population estimates across 5-yr age intervals (e.g., 60-64 yr). Prevalence ratios (PR) were calculated for multiple predictors of long-term brain health. Overall, MCI prevalence and dementia prevalence were n = 219(23.8%) and n = 82(8.9%), respectively. Each diagnosis was more prevalent in former NFL players across age-groups than U.S. norms, with greater disparities at relatively younger ages (e.g., 65-69 yr) compared with older ages. Greater prevalence of MCI and dementia was associated with self-reported concussion history (10+ vs 0; PRadjusted [95% CI] = 1.66 [1.02-2.71] and 2.61 [1.01-6.71], respectively); recent pain intensity (PRadjusted [95% CI] = 1.13 [1.07-1.20] and 1.15 [1.03-1.28]); and diagnoses of depression (PRadjusted [95% CI] = 2.70 [1.92-3.81] and 3.22 [1.69-6.14]), anxiety (PRadjusted [95% CI] = 1.96 [1.26-3.07] and 3.14 [1.47-6.74]), or both (PRadjusted [95% CI] = 3.11 [2.38-4.08] and 4.43 [2.71-7.25]). Higher MCI prevalence was related to sleep apnea (PRadjusted [95% CI] = 1.30 [1.06-1.60]); higher dementia prevalence was associated with age (5-yr interval, PRadjusted [95% CI] = 1.42 [1.26-1.60]) and race (non-White vs White, PRadjusted [95% CI] = 1.64 [1.07-2.53]). Self-reported MCI prevalence and dementia prevalence were higher in former NFL players than national estimates and were associated with numerous personal factors, including mood-related disorders and a high number of self-reported concussions. Predictors of higher MCI and dementia prevalence may be modifiable and warrant consideration by clinicians and researchers as potential targets to mitigate the onset of these conditions.