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J Neurotrauma. 2019 Dec 10. doi: 10.1089/neu.2019.6661. [Epub ahead of print]

Self-Reported Cognitive Function and Mental Health Diagnoses among Former Professional American-Style Football Players.

Author information

1
Football Players' Health Study at Harvard University, Harvard Medical School, Boston, Massachusetts.
2
Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
3
Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Department of Neurology, Hebrew SeniorLife and Harvard Medical School, Boston, Massachusetts.
4
Guttmann Brain Health Institut, Institut Guttmann, Universitat Autònoma de Barcelona, Barcelona, Spain.
5
College of Pharmacy, Oregon State University/Oregon Health Science University, Portland, Oregon.
6
Cardiovascular Performance Program, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
7
Berenson-Allen Center for Noninvasive Brain Stimulation and Division for Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
8
Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
9
Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts.
10
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
11
Department of Medicine, Cardiovascular Research Institute, Morehouse Medical School, Atlanta, Georgia.
12
Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital, Massachusetts General Hospital, Spaulding Rehabilitation Hospital, and Harvard Medical School, Boston, Massachusetts.
13
Department of Pediatrics and Orthopedics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.

Abstract

Clinical practice strongly relies on patients' self-report. Former professional American-style football players are hesitant to seek help for mental health problems, but may be more willing to report cognitive symptoms. We sought to assess the association between cognitive symptoms and diagnosed mental health problems and quality of life among a cohort of former professional players. In a cross-sectional design, we assessed self-reported cognitive function using items from the Quality of Life in Neurological Disorders (Neuro-QOL) Item Bank. We then compared mental health diagnoses and quality of life, assessed by items from the Patient-Reported Outcome Measurement Information System (PROMIS®), between former professional players reporting daily problems in cognitive function and former players not reporting daily cognitive problems. Of the 3758 former professional players included in the analysis, 40.0% reported daily problems due to cognitive dysfunction. Former players who reported daily cognitive problems were more likely to also report depression (18.0% vs. 3.3%, odds ratio [OR] = 6.42, 95% confidence interval [CI] [4.90-8.40]) and anxiety (19.1% vs. 4.3%, OR = 5.29, 95% CI [4.14-6.75]) than those without daily cognitive problems. Further, former players reporting daily cognitive problems were more likely to report memory loss and attention deficit(/hyperactivity) disorder and poorer general mental health, lower quality of life, less satisfaction with social activities and relationships, and more emotional problems. These findings highlight the potential of an assessment of cognitive symptoms for identifying former players with mental health, social, and emotional problems.

KEYWORDS:

cognitive function; football; mental health; quality of life

PMID:
31672091
DOI:
10.1089/neu.2019.6661

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