A-179 Association of Race and Cognitive Impairment in Retired NFL Athletes

Abstract

Abstract Objective: The Baseline Assessment Program (BAP) provided neuropsychological assessment to determine cognitive and psychological impairment in retired National Football League (NFL) athletes. The objective of the current study was to examine if an association exists between race and cognitive impairment using traditional race-based norms. Method: This is a retrospective analysis of 56 retired NFL athletes with repetitive head trauma secondary to contact sports. Participants identified as Black (n = 45) and White (n = 11) with a mean age of 52.52 years and 16.04 years of education. Five domains of cognition were assessed: Complex Attention and Processing Speed, Learning and Memory, Visual-Perceptual Processing, Language, and Executive Functioning. We estimated level of premorbid functioning accounting for race, education, region, and highest occupation held. We calculated levels of impairment for each domain and overall cognitive functioning by comparing t-scores with expected level of premorbid functioning (0.0, 1.0, 1.5, and 2.0 standard deviations [SDs] below expected level). Results: Our trend test revealed no significant association between race and levels of impairment for any of the domains assessed. Conclusion(s): Race was not associated with level of cognitive impairment. Null results may be due to unbalanced groups and positively skewed data. Level of cognitive impairment as outlined by the NFL is restrictive and resulted in few individuals with one or more SDs below estimated level of premorbid functioning. Future work may examine if these criteria or race-based norms result in false negative estimates of impairment, as this has clinical implications for access to resources and compensation for injury.