2024 American Academy of Neurology Abstract Website

Tahlia Bragg¹, Shania Baldwin¹, Minna Holleck¹, Erika Pettway¹, Fatima Tuz-Zahra², Yorghos Tripodis², Charles Bernick³, Charles Adler⁴, Laura Belcer⁵, Aaron Ritter³, Eric Reiman⁶, Jeffrey Cummings⁷, Martha E. Shenton⁸, Robert Stern¹, Michael Alosco¹, Robert Turner, II⁹
¹Boston University CTE Center, ²School of Public Health, Boston University, ³Cleveland Clinic, ⁴Mayo Clinic Arizona, ⁵Langone Health Center, New York University, ⁶Banner Alzheimer's Institute, ⁷University of Nevada, Las Vegas, ⁸Harvard Medical School, Brigham & Women's Hospital, ⁹George Washington University

Objective:

Explore potential associations between football exposure, maladaptive health behaviors, neurobehavioral, and neurocognitive outcomes among former American football players.

Background:

Maladaptive health behavior engagement (e.g., smoking, alcohol use, and substance use) is negatively associated with various neurocognitive and neuropsychiatric outcomes. Chronic traumatic encephalopathy is associated with repetitive head impact exposure. Long-term exposure to playing American football may influence maladaptive health behavior engagement.

Design/Methods:

Former professional (n=115) and college-level (n=59) football players and unexposed, asymptomatic controls (n=60) between 45-74 years-old from the DIAGNOSE CTE study were studied. Maladaptive health behaviors included sleep (i.e., MSQ Epworth Sleepiness Scale), cigarette smoking, physical activity, drug, and alcohol use. ANCOVA and regressions (logistic and linear) analyses investigated outcomes within and between subject groups, with respect to neuropsychological assessments based on predetermined cognitive/behavioral factors.

Results:

Former football players had more sleep complaints (β = 2.079, p = .007) and alcohol use (β = -1.942, p = .022) than controls, who engaged in less physical activity (odds ratio = .416, p = .041) than former players. No significant differences observed in level of play for health behaviors except opioid use; former college players used more than former NFL players (odds ratio = 3.96, p = .015, p_adj_. = .030). Years of play correlated with Executive Function and Psychomotor Speed factor performance (β = .222, p < .005; p_adj_.= .028). Sleep quality correlated with performances on the Visual Learning and Memory (β = .221, p_adj_.= .038) and Explosivity (β = .406, p_adj_.= .007) factors. Opioid use correlated with performances on the Visual Learning and Memory factor (β = .703, p = .001), Verbal Fluency factor (β = -.212, p_adj_.= .036), the Emotional Dyscontrol factor (β = .227, p_adj_.= .024).

Conclusions:

Sleep problems and opioid use were greater in former American football players and associated with several neuropsychological and neurobehavioral abnormalities.