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Playing American football before the age of 12 may have long-term consequences for players’ mood and behavior, according to a study involving 214 professional and amateur football players, published in the open access journal Translational Psychiatry.
Researchers at Boston University School of Medicine, USA found that football players who started playing before age 12 had more than twice the odds for clinical impairment in executive function (including analyzing, planning, and organizing tasks), regulating their behavior, and apathy, compared to players who started playing at age 12 or later. They also had more than three times the odds for depression. The effects appear to apply to players of all ages and levels of education, no matter how long they had played for (duration) and whether they were professional or amateur players (level of play).
Dr Robert Stern, the corresponding author of the study said: “Overall, our study provides further evidence that playing American football before age 12, and being hit in the head repeatedly through tackle football during a critical time of brain development, is associated with later-life problems with mood and behavior.”
This is the first study to show a relationship between age of first exposure to football and clinical dysfunction in a sample that included both professionals and amateurs who played only through high school or college. Previous research had only examined small samples of professional football players.
In order to investigate age of first exposure to American football and possible associations with long-term clinical implications, the authors scored self-reported measures of executive function, depression, behavioral regulation, and apathy that had been obtained by online questionnaire from 214 former American football players, who were 51 years on average at the time of the study. Cognitive function was assessed using a standardized, objective test administered over the telephone. All players took part in the Longitudinal Examination to Gather Evidence of Neurodegenerative Disease (LEGEND) study which investigates the long- and short-term consequences of exposure to repeated head impacts in athletes.
The researchers were surprised to find no association between age of first exposure and cognitive function (such as reasoning, memory, and attention) but they note that this may have had to do with how they gathered their data.
Dr Stern said: “Cognition was measured using a brief test that was administered over the telephone, rather than a more thorough, in-person neuropsychological examination, such as that used in previous research.”
The authors also caution that the findings cannot be generalized beyond to female players or other contact sports. Because this is a cross-sectional observational study, it does not allow for conclusions about cause and effect.
Dr Stern said: “It is important to note that participation in youth sports can have many benefits, including the development of leadership skills, social skills, and work ethic, not to mention the tremendous health benefits. The goal is to make sure that children can take advantage of all of the benefits of sports participation without the risk of long-term brain injury or disease. More research on this topic is needed before any recommendations on policy or rule changes can be made.”
Dr Stern added: “However, other research suggests that incurring repeated head impacts can lead to long-term consequences, and we should be doing what we can at all levels in all sports to minimize these repeated hits.”
Physicians, scientists, athletic trainers, coaches, officials and retired pro players from the U.S. and Canada will discuss the science of concussion, including prevention, diagnosis, treatment and future research. The summit focuses on ice hockey, but concussion-related topics apply to all sports.
The sessions include:
- “Which Hockey Players are at Greatest Risk and Why?
- “Can Financial Concerns and Pending Litigation Reduce Concussions in Pro Hockey?”
- “The Brain’s Response to Concussive Events: Updates on the Neurometabolic Cascade”
- “Pharmacologic Interventions Available now and on the Horizon”
- “Fish Oils, Supplements and their Neuroprotective Effects”
“Ultimately, we’re coming together to make the sport safer for our athletes,” says Michael Stuart, M.D., orthopedic surgeon and co-director, Mayo Clinic Sports Medicine. “Athletes at all levels are bigger, stronger and faster. Therefore, we must improve our ability to diagnose, treat and prevent traumatic brain injury.”
As with the first two summits in 2010 and 2013, participants will develop recommendations to improve the safety of the sport. Panels featuring former hockey players, medical providers and experts with coaching, officiating and athletic training backgrounds will provide ideas for potential solutions.
Past recommendations helped foster rule changes, including penalties for all hits to the head, a delay in body checking until the 14-and-under level and the elimination of dangerous acts, such as checking from behind. After these rule changes, Minnesota Hockey/Mayo Clinic Sports Medicine data showed a significant decline in penalties related to checking from behind.
“To reduce concussions in hockey, we must change the mindset and behavior of players, coaches and fans,” says Aynsley Smith, Ph.D., sport and exercise psychologist and concussion investigator at Mayo Clinic Sports Medicine. “From a young age, athletes need to learn proper body control and stick play to shift the focus from checking to improving skills. We are making progress, but there is more to do.”
Mayo Clinic Sports Medicine is facilitating this conference with support from USA Hockey, International Ice Hockey Federation, Thorne Science, Hockey Equipment Certification Committee, American College of Sports Medicine, the Johansson-Gund Endowment, the Brian Mark Foundation and the Martineau Gift.
Members of the media who want to attend or interview participants should RSVP to the contact below by Thursday, Sept. 21.
Building on the success of last year’s event, Bon Secours Health System and UPMC, a leader in concussion treatment worldwide, have come together with the Gaelic Athletic Association (GAA) to present Ireland’s second National Concussion Symposium, which will take place at Croke Park on October 7, 2017.
Leading concussion experts from UPMC in the United States, Bon Secours Health System in Ireland and sporting figures from the GAA will join together for another ground-breaking symposium which will share nationally the best practices, protocols and treatment of concussion today.
The event will feature a panel discussion involving Dr. Pat O’Neill (All-Ireland winning former manager and player with Dublin), Dr. Brendan Murphy (former Offaly hurler, current Tipperary hurling team doctor) and Oisín McConville (former Armagh footballer and All-Star winner) sharing their own experiences of concussion from their various involvements at all levels as players, team doctors and managers. The Dr. Brendan Murphy and Oisín McConville were on hand in Croke Park this morning to help publicise the event.
A limited number of spaces are still available for those wishing to attend. The event is aimed at medical professionals and those involved in academic research to benefit from the wisdom of those involved in ground breaking research and treatment in this field. Those wishing to attend can register their interest by email to email@example.com or call 087-9877391.
Further information on concussion, including the GAA’s Concussion Management Guidelines and Concussion E-learning course are available on the GAA website. http://learning.gaa.ie/Concussion