Age of First Exposure Does Not Relate to Post-Career Health in Former Professional American-Style Football Players,Sports Medicine

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Age of First Exposure Does Not Relate to Post-Career Health in Former Professional American-Style Football Players
Sports Medicine ( IF 9.3 ) Pub Date : 2024-06-26 , DOI: 10.1007/s40279-024-02062-9
Douglas P Terry ₁ , Rachel Grashow _{2,

3} , Grant L Iverson _{4,

5,

6,

7} , Paula Atkeson ₂ , Ran Rotem ₃ , Shawn R Eagle ₈ , Daniel H Daneshvar ₄ , Scott L Zuckerman ₁ , Ross D Zafonte _{2,

4,

5} , Marc G Weisskopf _{2,

3} , Aaron Baggish _{2,

9,

10}

Affiliation

Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, 1500 21st Ave South, Suite 4340, Village at Vanderbilt, Nashville, TN, 37212, USA.
Harvard Medical School, Football Players Health Study at Harvard University, Boston, MA, USA.
Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA.
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA, USA.
Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, USA.
Sports Concussion Program, Mass General for Children, Boston, MA, USA.
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA, USA.
Department of Cardiology, Lausanne University Hospital (CHUV) and Institute for Sport Science, University of Lausanne (ISSUL), Lausanne, Switzerland.

Objective

Prior studies examining small samples of symptomatic former professional football players suggest that earlier age of first exposure (AFE) to American football is associated with adverse later life health outcomes. This study examined a larger, more representative sample of former professional American football players to assess associations between AFE before age 12 (AFE < 12) and clinical outcomes compared with those who started at age 12 or older (AFE 12 +).

Methods

Former professional American football players who completed a questionnaire were dichotomized into AFE < 12 and AFE 12 + . AFE groups were compared on outcomes including symptoms of depression and anxiety, perceived cognitive difficulties, neurobehavioral dysregulation, and self-reported health conditions (e.g., headaches, sleep apnea, hypertension, chronic pain, memory loss, dementia/Alzheimer’s disease, and others).

Results

Among 4189 former professional football players (aged 52 ± 14 years, 39% self-reported as Black), univariable associations with negligible effect sizes were seen with AFE < 12, depressive symptoms (p = 0.03; η² = 0.001), and anxiety-related symptoms (p = 0.02; η² = 0.001) only. Multivariable models adjusting for age, race, body mass index, playing position, number of professional seasons, and past concussion burden revealed no significant relationships between AFE < 12 and any outcome. Linear and non-linear models examining AFE as a continuous variable showed similar null results.

Conclusions

In a large cohort of former professional American-style football players, AFE was not independently associated with adverse later life outcomes. These findings are inconsistent with smaller studies of former professional football players. Studies examining AFE in professional football players may have limited utility and generalizability regarding policy implications for youth sports.

中文翻译：

首次接触病毒的年龄与前职业美式橄榄球运动员的职业生涯后健康状况无关

目的

先前对有症状的前职业橄榄球运动员的小样本进行检查的研究表明，首次接触美式橄榄球的年龄较早（AFE）与不良的晚年健康结果相关。本研究检查了更大、更具代表性的前职业美式橄榄球运动员样本，以评估 12 岁前 AFE （AFE < 12）与临床结果之间的关联，与 12 岁或以上开始（AFE 12 +）的人相比。

方法

完成问卷的前职业美式橄榄球运动员被分为 AFE < 12 和 AFE 12 + 。比较 AFE 组的结局，包括抑郁和焦虑症状、感知认知困难、神经行为失调和自我报告的健康状况（例如，头痛、睡眠呼吸暂停、高血压、慢性疼痛、记忆丧失、痴呆/阿尔茨海默病等）。

结果

在 4189 名前职业橄榄球运动员（年龄 52 ± 14 岁，39% 自称是黑人）中，与 AFE < 12、抑郁症状（p = 0.03;η² = 0.001）和焦虑相关症状（p = 0.02;η² = 0.001）。根据年龄、种族、体重指数、比赛位置、职业赛季数和既往脑震荡负担进行调整的多变量模型显示，AFE < 12 与任何结果之间没有显着关系。将 AFE 作为连续变量进行检查的线性和非线性模型显示出相似的零结果。