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Examining later-in-life health risks associated with sport-related concussion and repetitive head impacts: a systematic review of case-control and cohort studies

Grant L Iverson Orcid Logo, Rudolph J Castellani, J David Cassidy, Geoff M Schneider, Kathryn J Schneider Orcid Logo, Ruben J Echemendia Orcid Logo, Julian E Bailes, K Alix Hayden, Inga K Koerte Orcid Logo, Geoffrey T Manley Orcid Logo, Michael McNamee Orcid Logo, Jon S Patricios Orcid Logo, Charles H Tator Orcid Logo, Robert C Cantu, Jiri Dvorak Orcid Logo

British Journal of Sports Medicine, Volume: 57, Issue: 12, Pages: 810 - 821

Swansea University Author: Michael McNamee Orcid Logo

Abstract

Objective Concern exists about possible problems with later-in-life brain health, such as cognitive impairment, mental health problems and neurological diseases, in former athletes. We examined the future risk for adverse health effects associated with sport-related concussion, or exposure to repeti...

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Published in: British Journal of Sports Medicine
ISSN: 0306-3674 1473-0480
Published: BMJ 2023
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa63688
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Abstract: Objective Concern exists about possible problems with later-in-life brain health, such as cognitive impairment, mental health problems and neurological diseases, in former athletes. We examined the future risk for adverse health effects associated with sport-related concussion, or exposure to repetitive head impacts, in former athletes.Design Systematic review.Data sources Search of MEDLINE, Embase, Cochrane, CINAHL Plus and SPORTDiscus in October 2019 and updated in March 2022.Eligibility criteria Studies measuring future risk (cohort studies) or approximating that risk (case-control studies).Results Ten studies of former amateur athletes and 18 studies of former professional athletes were included. No postmortem neuropathology studies or neuroimaging studies met criteria for inclusion. Depression was examined in five studies in former amateur athletes, none identifying an increased risk. Nine studies examined suicidality or suicide as a manner of death, and none found an association with increased risk. Some studies comparing professional athletes with the general population reported associations between sports participation and dementia or amyotrophic lateral sclerosis (ALS) as a cause of death. Most did not control for potential confounding factors (eg, genetic, demographic, health-related or environmental), were ecological in design and had high risk of bias.Conclusion Evidence does not support an increased risk of mental health or neurological diseases in former amateur athletes with exposure to repetitive head impacts. Some studies in former professional athletes suggest an increased risk of neurological disorders such as ALS and dementia; these findings need to be confirmed in higher quality studies with better control of confounding factors.
Item Description: Systematic review
College: Faculty of Science and Engineering
Funders: Funding for some of the administrative aspects of the numerous systematic reviews prepared for the 6th International Consensus Conference on Concussion in Sport was provided through an educational grant from the Concussion in Sport International Consensus Conference Organising Committee through Public Creations for partial administrative and operational costs associated with the writing of the systematic reviews. Partial support for travel to the Consensus Conference, for some of the authors, also was provided by the International Olympic Committee.
Issue: 12
Start Page: 810
End Page: 821