Disclosures: Stern reports receiving philanthropic donations from former University of Notre Dame football players and family members; grants from the NINDS and NIA; consulting fees from Biogen and Lundbeck; and royalties for published neuropsychological tests from Psychological Assessment Resources, Inc. He also reports serving as a board member for King-Devick Technologies, for which he receives stock options, and member of the court-appointed Medical Scientific Committee for the National Collegiate Athletic Association Student-Athlete Concussion Injury Litigation. Please see the study for all other authors’ relevant financial disclosures.
April 21, 2022
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Cognitive impairment, headaches, CVD more common in former college football players

Disclosures: Stern reports receiving philanthropic donations from former University of Notre Dame football players and family members; grants from the NINDS and NIA; consulting fees from Biogen and Lundbeck; and royalties for published neuropsychological tests from Psychological Assessment Resources, Inc. He also reports serving as a board member for King-Devick Technologies, for which he receives stock options, and member of the court-appointed Medical Scientific Committee for the National Collegiate Athletic Association Student-Athlete Concussion Injury Litigation. Please see the study for all other authors’ relevant financial disclosures.
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Former college football players had a significantly higher prevalence of several health issues later in life than nonplayers, according to findings published in JAMA Network Open.

“In this cohort study, playing college football was associated with both positive and negative long-term health outcomes,” Robert A. Stern, PhD, a professor of neurology, neurosurgery and anatomy and neurobiology at the Boston University School of Medicine and the director of the clinical core at the Boston University Alzheimer’s Disease Center, and colleagues wrote.

Prevalence of health outcomes later in life among former college football players vs. a nationally representative sample of men
Phelps A, et al. JAMA Netw Open. 2022;doi:10.1001/jamanetworkopen.2022.8775.

Stern and colleagues evaluated data from 447 former University of Notre Dame football players aged 59 to 75 years who were senior players from 1964 to 1980. Living players (n = 216) or the families of deceased players completed a health outcomes survey from December 2018 to May 2019. The researchers compared standardized mortality ratios of all causes and specific causes of death among former football players with ratios for 638 men in the Health and Retirement Study (HRS), representing the general U.S. population. The median age of the former players was 67 years and the median age of men in the HRS sample was 66 years.

In total, 15% of the former players who were surveyed went on to play football professionally, according to Stern and colleagues. Health outcomes did not differ significantly among those who played professionally and those who did not.

Former players had a significantly higher prevalence of cognitive impairment (5% vs. 1%; P = .02), headaches (10% vs. 4%; P = .001), CVD (33% vs. 20%; P = .001), hypercholesterolemia (52% vs. 29%; P = .001) and alcohol use (86% vs. 77%; P = .02) compared with men in the HRS sample. Stern and colleagues also reported that mortality from brain and other nervous system cancers was significantly higher among former players (standard mortality ratio [SMR] = 3.82; 95% CI, 1.04-9.77).

However, former players had a lower prevalence of diabetes (11% vs. 23%; P = .001); all-cause mortality (SMR 0.54; 95% CI, 0.42-0.67) and heart-related mortality (SMR = 0.64; 95% CI, 0.39-0.99); circulatory disorders (SMR = 0.23; 95% CI, 0.03-0.83); respiratory disorders (SMR = 0.13; 95% CI, 0-0.7); digestive system disorders (SMR = 0.13; 95% CI, 0-0.74); lung cancer (SMR = 0.26; 95% CI, 0.05- 0.77) and violence (SMR = 0.10; 95% CI, 0-0.58), according to the researchers.

Former players had a significantly lower risk for mortality from CVD despite results indicating a higher prevalence of self-reported CVD compared with the general population, Stern and colleagues wrote.

“With the increasing number of living former college football players, additional research is needed to expand on our findings and to provide all stakeholders with accurate, unbiased data and guidance to maximize factors that improve later-life health outcomes and eliminate or reduce factors that may increase risk for later-life morbidity and mortality,” the researchers added.