Maximum Wellness, Episode 119: Retired NFL Players at Risk for Mild Cognitive Impairment After Age 50

New research – “Mild Cognitive Impairment and Dementia Reported by Former Professional Football Players over 50 Years of Age,  An NFL-Long Study”, which appeared in the March 2022 issue of Medicine & Science in Sports & Exercise, reports on the increased risk that former NFL players over the age of 50 have for mild cognitive impairment (MCI)

A diverse group of researchers from the Department of Exercise and Sports Science and Center for the Study of Retired Athletes, University of North Carolina and the Department of Neurosurgery/Neurology, Medical College of Wisconsin, among others, concluded that, “Self-reported MCI prevalence and dementia prevalence were higher in former NFL players than national estimates and were associated with numerous personal factors, including mood-related disorders and a high number of self-reported concussions.”

The estimates of MCI risk in Americans is 24 to 32%. While not completely understood, the risk seems to be related to be age, race, social, educational, health status (osteoarthritis and cardiovascular disease) and mood (depression).

The investigators comment that, “Traumatic brain injury (TBI) may also increase risk for developing MCI and dementia-related disorders. With respect to sport-related TBI, the prevalence of MCI may be higher in former National Football League (NFL) players with three or more self-reported concussions compared with those with fewer, but not necessarily for Alzheimer’s disease (AD).”

The overall incidence of AD in former NFL players is higher than for the average American man – with the greatest disparity tied to males under 70 years old.

Based on the need to clarify a retired NFL players risk to MCI, after the age of 50, the investigators contacted 15,025 former NFL players of all ages. Former players were eligible for the study, if they had at least one full season and were 50 years or older. They were asked to complete an online questionnaire or paper hard copy.

The justification by the researchers for a 50-year old cutoff age was that, “It represents the lower-bound age in which neurodegenerative diseases with typical earlier onset first occur (e.g., early onset/autosomal AD, behavioral variant of frontotemporal dementia).”

The questionnaire used was expanded from a prior questionnaire in an ongoing study – Neurologic Function Across the Lifespan: A Prospective, Longitudinal, and Translational Study for Former National Football League Players (NFL-Long).

The questionnaire examined the general health of former NFL players, while also acquiring information regarding the former player’s personal demographics; football playing history; medical history; concussion history; musculoskeletal injury history; self-reported psychological, physical, and cognitive functioning; health-related quality of life; and current substance use-and health-related behaviors.

It was determined that, “In this subset of former NFL players, history of 10 or more sport-related concussions, lifetime diagnoses of depression and/or anxiety, and greater recent pain intensity were each associated with higher prevalence of MCI and dementia.”

In addition, “Sleep apnea was also associated with a greater prevalence of MCI. Older age and self-identifying as non-White were associated with a greater prevalence of dementia.”

As to the implications, “This study, concluded the researchers, “suggests that there may be preventative and therapeutic targets that might mitigate the onset of MCI or dementia-related disorders.”