Long Term Implications of Contact Football Head Trauma

Abstract

Effects of head trauma experienced in contact football is a growing health concern. Limited research has been conducted to assess exposures to later concussion related symptoms among former college football players. PURPOSE: To quantify the amount of contact football participation, diagnosed concussions, non-diagnosed self-reported head trauma, and the frequency of symptoms associated with post-concussion syndrome among former college football players. METHODS: We surveyed 275 former college football players who were at least 10 years post competition. Respondents provided data on their youth, high school, and college playing experience, undiagnosed head injury, diagnosed concussions, and concussion related symptoms (CRSs). CRSs included cognitive impairment, impulsive behavior, depression, shot term memory loss, difficulty planning, emotional instability, substance abuse, and suicidal thoughts, were combined into a frequency of symptoms score (range 0-8). A Poisson regression was conducted to examine the association between playing experience and reported head trauma with reported symptom count. RESULTS: The majority of participants reported no diagnosed concussions in college (80%), but a large number reported non-diagnosed football related head injuries (67%) that might have resulted in a concussion. A majority of participants (59%) reported no concussion related symptoms. After controlling for age, youth and high school football participation, playing time, non-football concussions, and participation in post-college football (pro, semi-pro), diagnosed concussions in high school or college did not significantly predict concussion symptoms later in life. However, non-diagnosed head injury significantly predicted concussion symptoms (b=.47, p<.001) as did post-college play (b=.71, p<.001). CONCLUSIONS: Diagnosed concussions were not associated with later self-reported concussion related symptoms. Non-diagnosed head injuries, which are less likely to be managed by a healthcare professional, were significantly associated with CRSs later in life. These findings suggest that proper identification and management of concussions may prevent later symptoms, but more data are needed to test this conclusion.