An 18-Year Study of Changes in Neurocognitive Function and Associations with Repetitive Head Trauma among Former Collegiate American Football Players: A Case Series.

OBJECTIVES

To assess changes in neurocognitive test scores among former collegiate American football players over 18 years and examine associations with head trauma history.

METHODS

Former collegiate American football players (n = 31; aged = 38.4 ± 1.3 years) self-reported their concussion history and repetitive head impact exposure (Head Impact Exposure Estimate). Neurocognitive testing was conducted at two time-points (during college [T1] and 18-year follow-up [T2]) via Hopkins Verbal Learning Test-Revised Immediate and Delayed Recall; Verbal fluency; Symbol Digit Modalities Test; and Trail-Making Test-B. Raw score changes were calculated, with accompanying Cohen's d effect sizes and coefficients of variation. Repeated-measures analyses of covariance models were fit to examine changes in test performance. Multivariable linear regression models tested associations of sport-related concussion history and repetitive head impact exposure with change scores.

RESULTS

No significant changes in cognitive test performance were observed (ps ≥ .06). Individual-level changes exhibited high variability (coefficients of variation ≥ 244%), and group-level effects were small to medium (d ≤ 0.41). Neither sport-related concussion history nor repetitive head impacts were related to change scores (ps > .05).

CONCLUSIONS

Group-level test scores did not change over 18 years among former collegiate football players now in midlife, though individual-level variability was high. Sport-related concussion and head impact exposure estimates were not related to change. Longitudinal studies are essential to understand cognitive trajectories of former football players and factors influencing those trajectories.