Playing American football before age 12 is linked to long-term neuropsychiatric and cognitive problems

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Tack­le foot­ball before age 12 may boost risks of cog­ni­tive, mood dis­or­ders (Ars Technica):

“Tak­ing hard knocks ear­ly in life could shove foot­ball play­ers toward neu­ro­log­i­cal prob­lems lat­er, a new study suggests.

Among 214 for­mer ama­teur and pro­fes­sion­al male foot­ball play­ers, those who start­ed play­ing early—particularly before the age of 12—had greater risks of report­ing depres­sion and impaired behav­ioral reg­u­la­tion and exec­u­tive func­tion around their 50s, researchers found…Com­pared with those who start­ed lat­er, play­ers that start­ed ear­li­er than age 12 had more than twice the odds for hav­ing “clin­i­cal­ly mean­ing­ful impair­ments in report­ed behav­ioral reg­u­la­tion, apa­thy and exec­u­tive func­tion” and more than three times the odds of hav­ing clin­i­cal­ly ele­vat­ed depres­sion scores. The links held up when the researchers looked at a con­tin­u­um of start­ing times…

There are sev­er­al lim­i­ta­tions of the study, of course, includ­ing that it only has the pow­er to note cor­re­la­tions, not cau­sa­tions. The play­ers involved in the study were also a “con­ve­nience sam­ple,” mean­ing they were self-select­ed and there­fore could cause bias in the results. The study doesn’t specif­i­cal­ly account for dif­fer­ent styles or pro­tec­tive gear used through­out dif­fer­ent eras of youth football…”

The Study

Age of first expo­sure to Amer­i­can foot­ball and long-term neu­ropsy­chi­atric and cog­ni­tive out­comes (Trans­la­tion­al Psychiatry)

• Abstract: Pre­vi­ous research sug­gests that age of first expo­sure (AFE) to foot­ball before age 12 may have long-term clin­i­cal impli­ca­tions; how­ev­er, this rela­tion­ship has only been exam­ined in small sam­ples of for­mer pro­fes­sion­al foot­ball play­ers. We exam­ined the asso­ci­a­tion between AFE to foot­ball and behav­ior, mood and cog­ni­tion in a large cohort of for­mer ama­teur and pro­fes­sion­al foot­ball play­ers. The sam­ple includ­ed 214 for­mer foot­ball play­ers with­out oth­er con­tact sport his­to­ry. Par­tic­i­pants com­plet­ed the Brief Test of Adult Cog­ni­tion by Tele­phone (BTACT), and self-report­ed mea­sures of exec­u­tive func­tion and behav­ioral reg­u­la­tion (Behav­ior Rat­ing Inven­to­ry of Exec­u­tive Func­tion-Adult Ver­sion Metacog­ni­tion Index (MI), Behav­ioral Reg­u­la­tion Index (BRI)), depres­sion (Cen­ter for Epi­demi­o­log­ic Stud­ies Depres­sion Scale (CES‑D)) and apa­thy (Apa­thy Eval­u­a­tion Scale (AES)). Out­comes were con­tin­u­ous and dichotomized as clin­i­cal­ly impaired. AFE was dichotomized into <12 and greater than or equal to 12…Younger AFE to foot­ball, before age 12 in par­tic­u­lar, was asso­ci­at­ed with increased odds for impair­ment in self-report­ed neu­ropsy­chi­atric and exec­u­tive func­tion in 214 for­mer Amer­i­can foot­ball play­ers. Lon­gi­tu­di­nal stud­ies will inform youth foot­ball pol­i­cy and safe­ty decisions.

Study in Context

• Pub­lic Brain Health vs. Pri­vate Brain Research Funds: How the NFL tried to influ­ence NIH studies
• Con­cus­sion diag­noses among chil­dren and teenagers increased by 71% from 2010 through 2015
• FDA clears two com­put­er­ized cog­ni­tive tests to assist in med­ical eval­u­a­tions fol­low­ing brain injury or concussion