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Prevalence and Characterization of Mild Cognitive Impairment in Retired National Football League Players

Published online by Cambridge University Press:  01 August 2013

Christopher Randolph ,
Stella Karantzoulis  and
Kevin Guskiewicz
Christopher Randolph*
Affiliation:
Department of Neurology, Loyola University Medical Center, Maywood, Illinois
Stella Karantzoulis
Affiliation:
Department of Neurology, New York University Langone Medical Center, New York, New York
Kevin Guskiewicz
Affiliation:
Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Center for the Study of Retired Athletes, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
*
Correspondence and reprint requests to: Christopher Randolph, 1 East Erie, Suite 353, Chicago, IL 60611. E-mail: crandol@lumc.edu
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Abstract

It has been hypothesized that exposure to repetitive head trauma from contact sports over a long-playing career may eventuate in an increased risk of late-life cognitive impairment. There are currently two competing hypotheses about the possible mechanism underlying such impairment. One is the presence of a unique neurodegenerative disorder known as “chronic traumatic encephalopathy” (CTE). The other is diminished cerebral reserve leading to the earlier clinical expression of age-related neurodegenerative diseases such as mild cognitive impairment (MCI) and Alzheimer's disease (AD). The present study examined informant AD8 inventory data in a sample of 513 retired National Football League (NFL) players. These data were indicative of possible cognitive impairment in 35.1% of this relatively young sample. A comparison of neurocognitive profiles in a subsample of this group to a clinical sample of patients with a diagnosis of MCI due to AD revealed a highly similar profile of impairments. Overall, the data suggest that there may be an increased prevalence of late-life cognitive impairment in retired NFL players, which may reflect diminished cerebral reserve. The findings are considered preliminary, but emphasize the need for larger, controlled studies on this issue. (JINS, 2013, 19, 1–8)

Keywords

ConcussionFootballSportsCTEMCI
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 8 , September 2013 , pp. 873 - 880
Copyright
Copyright © The International Neuropsychological Society 2013 

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References

Albert, M.S., DeKosky, S.T., Dickson, D., Dubois, B., Feldman, H.H., Fox, N.C., Phelps, C.H. (2011). The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers and Dementia, 7, 270–279.CrossRefGoogle ScholarPubMed
Baron, S.L., Hein, M.J., Lehman, E., Gersic, C.M. (2012). Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players. American Journal of Cardiology, 109, 889–896.CrossRefGoogle ScholarPubMed
Beatty, W.W., Ryder, K.A., Gontkovsky, S.T., Scott, J.G., McSwan, K.L., Bharucha, K.J. (2003). Analyzing the subcortical dementia syndrome of Parkinson's disease using the RBANS. Archives of Clinical Neuropsychology, 18, 509–520.Google ScholarPubMed
Bennett, D.A., Schneider, J.A., Arvanitakis, Z., Kelly, J.F., Aggarwal, N.T., Shah, R.C., Wilson, R.S. (2006). Neuropathology of older persons without cognitive impairment from two community-based studies. Neurology, 66, 1837–1844.CrossRefGoogle ScholarPubMed
Broglio, S.P., Eckner, J.T., Martini, D., Sosnoff, J.J., Kutcher, J.S., Randolph, C. (2011). Cumulative head impact burden in high school football. Journal of Neurotrauma, 28, 2069–2078.CrossRefGoogle ScholarPubMed
Corsellis, J.A., Bruton, C.J., Freeman-Browne, D. (1973). The aftermath of boxing. Psychological Medicine, 3, 270–303.CrossRefGoogle ScholarPubMed
Delaney, J.S., Lacroix, V.J., Leclerc, S., Johnston, K.M. (2000). Concussions during the 1997 Canadian Football League season. Clinical Journal of Sports Medicine, 10, 9–14.CrossRefGoogle ScholarPubMed
Donnell, A.J., Pliskin, N., Holdnack, J., Axelrod, B., Randolph, C. (2007). Rapidly-administered short forms of the Wechsler Adult Intelligence Scale-3rd edition. Archives of Clinical Neuropsychology, 22, 917–924.CrossRefGoogle ScholarPubMed
Duma, S.M., Manoogian, S.J., Bussone, W.R., Brolinson, P.G., Goforth, M.W., Donnenwerth, J.J., Greenwald, R.M., Chu, J.J., Crisco, J.J. (2005). Analysis of real-time head accelerations in collegiate football players. Clinical Journal of Sports Medicine, 15, 3–8.CrossRefGoogle ScholarPubMed
Galvin, J.E., Roe, C.M., Powlishta, K.K., Coats, M.A., Muich, S.J., Grant, E., Miller, J.P., Storandt, M., Morris, J.C. (2005). The AD8: A brief informant interview to detect dementia. Neurology, 65, 559–564.CrossRefGoogle ScholarPubMed
Guskiewicz, K.M., Marshall, S.W., Bailes, J., McCrea, M., Cantu, R.C., Randolph, C., Jordan, B.D. (2005). Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery, 57, 719–726; discussion 719–726.CrossRefGoogle ScholarPubMed
Guskiewicz, K.M., McCrea, M., Marshall, S.W., Cantu, R.C., Randolph, C., Barr, W.B., Onante, J.A., Kelly, J.P. (2003). Cumulative effects associated with recurrent concussion in collegiate football players: The NCAA concussion study. Journal of the American Medical Association, 290, 2549–2555.CrossRefGoogle ScholarPubMed
Hart, J. Jr, Kraut, M.A., Womack, K.B., Strain, J., Didehbani, N., Bartz, E., Conover, H., Mansinghani, S., Lu, H., Cullum, C.M. (2013). Neuroimaging of cognitive dysfunction and depression in aging retired National Football League players: A cross-sectional study. JAMA Neurology, 70, 326–335.CrossRefGoogle ScholarPubMed
Lehman, E.J., Hein, M.J., Baron, S.L., Gersic, C.M. (2012). Neurodegenerative causes of death among retired National Football League players. Neurology, 79, 1970–1974.CrossRefGoogle ScholarPubMed
Macciocchi, S.N., Barth, J.T., Littlefield, L.M., Cantu, R. (2001). Multiple concussions and neuropsychological functioning in collegiate football players. Journal of Athletic Training, 303–306.Google ScholarPubMed
McCrory, P., Meeuwisse, W.H., Aubry, M., Cantu, B., Dvorak, J., Echemendia, R.J., Turner, M. (2013). Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. British Journal of Sports Medicine, 47, 250–258.CrossRefGoogle ScholarPubMed
McKee, A.C., Cantu, R.C., Nowinski, C.J., Hedley-Whyte, E.T., Gavett, B.E., Budson, A.E., Stern, R.A. (2009). Chronic traumatic encephalopathy in athletes: Progressive tauopathy after repetitive head injury. Journal of Neuropathology and Experimental Neurology, 68, 709–735.CrossRefGoogle ScholarPubMed
McKee, A.C., Stein, T.D., Nowinski, C.J., Stern, R.A., Daneshvar, D.H., Alvarez, V.E., Cantu, R.C. (2013). The spectrum of disease in chronic traumatic encephalopathy. Brain, 136(Pt 1), 43–64.CrossRefGoogle ScholarPubMed
Mihalik, J.P., Bell, D.R., Marshall, S.W., Guskiewicz, K.M. (2007). Measurement of head impacts in collegiate football players: an investigation of positional and event-type differences. Neurosurgery, 61, 1229–1235; discussion 1235.CrossRefGoogle ScholarPubMed
Miller, H. (1966). Mental after-effects of head injury. Proceedings of the Royal Society of Medicine, 59, 257–261.CrossRefGoogle ScholarPubMed
Omalu, B.I., DeKosky, S.T., Hamilton, R.L., Minster, R.L., Kamboh, M.I., Shakir, A.M., Wecht, C.H. (2006). Chronic traumatic encephalopathy in a national football league player: part II. Neurosurgery, 59, 1086–1092; discussion 1092–1083.CrossRefGoogle Scholar
Omalu, B.I., DeKosky, S.T., Minster, R.L., Kamboh, M.I., Hamilton, R.L., Wecht, C.H. (2005). Chronic traumatic encephalopathy in a National Football League player. Neurosurgery, 57, 128–134; discussion 128–134.CrossRefGoogle Scholar
Randolph, C. (1998). Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). San Antonio, TX: The Psychological Corporation.Google ScholarPubMed
Randolph, C., Gold, M., Morimoto, B. (2012). The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in progressive supranuclear palsy: Baseline data from the Allon Therapeutics AL-108-231 multinational clinical trial. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 8, 172.CrossRefGoogle Scholar
Randolph, C., Kirkwood, M.W. (2009). What are the real risks of sport-related concussion, and are they modifiable? Journal of the International Neuropsychological Society, 15, 512–520.CrossRefGoogle ScholarPubMed
Randolph, C., Tierney, M.C., Mohr, E., Chase, T.N. (1998). The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): Preliminary clinical validity. Journal of Clinical and Experimental Neuropsychology, 20, 310–319.CrossRefGoogle ScholarPubMed
Roberts, G.W., Allsop, D., Bruton, C. (1990). The occult aftermath of boxing. Journal of Neurology, Neurosurgery, and Psychiatry, 53, 373–378.CrossRefGoogle ScholarPubMed
Roberts, R.O., Geda, Y.E., Knopman, D.S., Cha, R.H., Pankratz, V.S., Boeve, B.F., Petersen, R.C. (2012). The incidence of MCI differs by subtype and is higher in men: the Mayo Clinic Study of Aging. Neurology, 78, 342–351.CrossRefGoogle ScholarPubMed
Schnebel, B., Gwin, J.T., Anderson, S., Gatlin, R. (2007). In vivo study of head impacts in football: a comparison of National Collegiate Athletic Association Division I versus high school impacts. Neurosurgery, 60, 490–495; discussion 495–496.CrossRefGoogle Scholar
Tervo, S., Kivipelto, M., Hanninen, T., Vanhanen, M., Hallikainen, M., Mannermaa, A., Soininen, H. (2004). Incidence and risk factors for mild cognitive impairment: a population-based three-year follow-up study of cognitively healthy elderly subjects. Dementia and Geriatric Cognitive Disorders, 17, 196–203.CrossRefGoogle ScholarPubMed
Welsh, K., Breitner, J., Magruder-Habib, K. (1993). Detection of dementia in the elderly using Telephone Screening of Cognitive Status. Neuropsychiatry Neuropsychology and Behavioral Neurology, 6, 103–110.Google Scholar