For NFL players, position & career length play key roles in long-term brain health

BOSTON — Playing in the National Football League is the dream of countless youngsters across America, and certainly for plenty of parents, too. But many adults are now questioning whether chasing that dream is worth it, with football being often linked to concussions and the risk of chronic traumatic encephalopathy (CTE). Adding to that growing body of research is a recent study of former NFL players by scientists at the Harvard T.H. Chan School of Public Health and Harvard Medical School. The study found that the number of years spent playing in the NFL can expose players to greater long-term risk of serious cognitive problems.

Researchers say in addition to career length, certain positions were also more prone to these neurological and mental health conditions. These problems include memory deficits, depression, anxiety, and confusion among ex-NFLers.

The study analyzed data from nearly 3,500 former NFL players who completed surveys about their career spans, head or neck injuries they suffered, and potential symptoms consistent with concussions. Players were also asked about symptoms of depression or anxiety they’d experienced after their careers ended.

The results weren’t a surprise to the authors. Surveys revealed that players who’d suffered concussions had an elevated risk for cognitive issues. The authors found these problems tended to persist over time, with some players experiencing cognitive symptoms for as long as 20 years after suffering their concussions.

“Our findings confirm what some have suspected–a consistently and persistently elevated risk for men who play longer and who play in certain positions,” said lead investigator Andrea Roberts, a research scientist at the Harvard T.H. Chan School of Public Health, in a university news release. “Our results underscore the importance of preventing concussions, vigilant monitoring of those who suffer them and finding new ways to mitigate the damage from head injury.”

For the study, the players were given a concussion score based on the number of their concussion symptoms and the severity of them. Overall, 12% (about one in eight) of the former NFL players reported symptoms of severe cognitive problems, compared to about two percent of the general population.

Length of one’s career was a major factor, it seemed. Risk for diminished cognition increased for every year played, and every five seasons carried a nearly 20 percent increase. Participants who’d played at least 10 seasons were twice as likely to say they’d battled severe cognitive problems than those who only played for just one season.

Career length also mattered when it came to depression or anxiety More than a quarter of the participants admitted to having symptoms of one of the two conditions, while slightly fewer than a fifth (18 percent) dealt with symptoms of both. Every five seasons played added another 9 percent risk.

The researchers are quick to point out that not everyone who has suffered a concussion will experience cognitive or mental problems.

Still, the study found that the longer players participate in football, the more likely they are to suffer a head injury that increases their risk for neurocognitive maladies. Moreover, certain positions on the field have a greater risk of concussion. In particular, kickers, punters, and quarterbacks had the fewest cognitive issues of the study group. Conversely, running backs, linebackers, and special teams coverage players suffered the most concussions or head injuries.

The authors say that players who reported the most concussions symptoms were 22 times more likely to experience long-term cognition struggles versus players who reported the fewest symptoms. They were also six times more likely to battle depression and/or anxiety.

In January, Carolina Panthers star linebacker Luke Kuechly retired from the NFL after just eight seasons at age 28. Though he didn’t point specifically to the issue, many believe the seven-time Pro Bowler’s history of concussions may have played a key role in his decision to hang up his cleats for good.

“Clearly, not everyone who sustains a concussion is destined for cognitive trouble, but the results of the research highlight just how critical it is to continue to find ways to prevent head injuries from occurring in the first place because of the many downstream and long-lasting effects on physical, cognitive and mental health,” says Ross Zafonte, the Earle P. and Ida S. Charlton Professor of Physical Medicine and Rehabilitation and head of the Department of Physical Medicine and Rehabilitation at Harvard Medical.

The findings also showed that there was no link between starting football at a young age and cognitive problems into adulthood.

The study is published in The American Journal of Sports Medicine.