Abstract
Previous studies have examined associations of concussion history (CHx) and depression in former National Football League (NFL) players. However, markers of depression are usually based on self-reported physician diagnoses, and not validated symptom scales. PURPOSE: Describe depression diagnoses, symptom severity, and their associations with CHx in a cohort of older former NFL players. METHODS: Former NFL players aged 50+ years (n = 892) completed a questionnaire in a cross-sectional study. Participants reported: demographic information; sport history; and medical history. Pertinent variables included: lifetime CHx (categorized ordinally: 0, 1-2, 3-5, 6-9, 10+); self-reported physician diagnosis of depression; and the PROMIS® 4-item Depressive Symptoms battery [transformed to T-Scores reflecting US population normative mean = 50, and standard deviation (SD) = 10; higher scores indicating worse symptoms]. Mantel-Haenszel Chi-Square (χ2C(MH)) tests assessed associations of CHx with physician-diagnosed depression; ANOVAs with Tukey post-hoc tests assessed the association of CHx with depressive symptoms. RESULTS: Participants were aged 65 ± 9 years. CHx distribution based on groups was 0 (11.7%), 1-2 (15.1%), 3-5 (24.4%), 6-9 (21.2%), and 10+ (27.6%); 19.5% reported physician-diagnosed depression. The average depressive symptom score was 49.6 ± 9.4. Higher physician-diagnosed depression prevalence was associated with higher self-reported CHx (χ2C(MH) = 45.7, P < 0.001). Higher depressive symptom scores were found in higher self-reported. Post-hoc comparisons indicating significant differences are shown in Table 1. CONCLUSIONS: Increased lifetime CHx may be associated with both depression diagnosis and self-reported symptoms, though average symptom scores for all CHx groups fell within average US population norms. Continued examination of depression operationalization will help ensure valid measurement of pertinent health concerns.
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