Rigney Grant H, Dugan John E, Bishay Anthony, Jonzzon Soren, Jo Jacob, Williams Kristen L, Zuckerman Scott L, Terry Douglas P
Harvard Medical School, Boston, MA, USA.
Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Sports Med. 2025 May 14. doi: 10.1007/s40279-025-02239-w.
Younger age of first exposure (AFE) to American Football (football) is associated with later-life health problems among former professional athletes in several studies; however, studies examining amateur (i.e., nonprofessional) athletes are less clear.
In a cohort of former amateur American Football players, this study assessed whether AFE to football was associated with: (1) psychiatric and neurobehavioral symptoms, (2) cognitive difficulties, (3) general health problems, (4) motor symptoms, and (5) functional status.
A cross-sectional survey study was conducted using the ResearchMatch platform. The key independent variable was age of first exposure to football (AFE < 12 versus AFE ≥ 12). Main outcomes included depressive symptoms (Patient Health Questionnaire-9; PHQ-9), anxiety symptoms (Generalized Anxiety Disorders-7; GAD-7), cognitive difficulties (British Columbia Cognitive Complaints Inventory; BC-CCI), Neurobehavioral Symptom Inventory (NSI) score, and prevalence of other health problems. Multivariable regressions were assessed for associations between AFE and outcome variables.
In total, 107 male participants with exposure to football (mean age: 60.6 ± 15.1 years) reported an average of 4.2 ± 2.7 years of exposure to football, with an average AFE of 11.7 ± 3.1 years. In multivariable analyses, AFE < 12 was not a significant predictor of PHQ-9 (unstandardized beta, B: 0.51, standard error, SE: 1.25, p = 0.682), GAD-7 (B: 0.09, SE: 0.95, p = 0.926), NSI (B: - 0.56, SE: 2.93, p = 0.850), or BC-CCI (B: - 0.65, SE: 0.77, p = 0.403). However, more prior concussions were associated with worse PHQ-9 (B: 0.44, SE: 0.10, p < 0.001), GAD-7 (B: 0.33, SE: 0.07, p < 0.001), NSI (B: 1.04, SE: 0.23, p < 0.001), and BC-CCI scores (B: 0.26, SE: 0.06, p < 0.001). AFE < 12 did not predict general health problems or independent functional status.
AFE to football was not associated with adverse psychiatric, cognitive, neurobehavioral, or general health outcomes among young, former amateur American Football players. However, more lifetime concussions were associated with adverse cognitive and psychiatric health outcomes. Future studies should examine similar outcomes in older cohorts with more comorbidities to further minimize potential confounding between general health and lack of later-life symptoms.
多项研究表明，美国橄榄球（橄榄球）首次接触年龄（AFE）较小与前职业运动员晚年的健康问题有关；然而，针对业余（即非职业）运动员的研究结果尚不明确。
在一组前业余美式橄榄球运动员中，本研究评估橄榄球的AFE是否与以下方面相关：（1）精神和神经行为症状，（2）认知困难，（3）一般健康问题，（4）运动症状，以及（5）功能状态。
使用ResearchMatch平台进行了一项横断面调查研究。关键自变量为首次接触橄榄球的年龄（AFE＜12岁与AFE≥12岁）。主要结局包括抑郁症状（患者健康问卷-9；PHQ-9）、焦虑症状（广泛性焦虑障碍量表-7；GAD-7）、认知困难（不列颠哥伦比亚认知投诉量表；BC-CCI）、神经行为症状量表（NSI）得分以及其他健康问题的患病率。评估多变量回归以分析AFE与结局变量之间的关联。
共有107名接触过橄榄球的男性参与者（平均年龄：60.6±15.1岁）报告平均接触橄榄球4.2±2.7年，平均AFE为11.7±3.1岁。在多变量分析中，AFE＜12岁不是PHQ-9（未标准化β系数，B：0.51，标准误，SE：1.25，p = 0.682）、GAD-7（B：0.09，SE：0.95，p = 0.926）、NSI（B：-0.56，SE：2.93，p = 0.850）或BC-CCI（B：-0.65，SE：0.77，p = 0.403）的显著预测因素。然而，既往脑震荡次数越多，与更差的PHQ-9（B：0.44，SE：0.10，p＜0.001）、GAD-7（B：0.33，SE：0.07，p＜0.001）、NSI（B：1.04，SE：0.23，p＜0.001）以及BC-CCI得分（B：0.26，SE：0.06，p＜0.001）相关。AFE＜12岁不能预测一般健康问题或独立功能状态。
对于年轻的前业余美式橄榄球运动员，橄榄球的AFE与不良的精神、认知、神经行为或一般健康结局无关。然而，一生中有更多的脑震荡与不良的认知和精神健康结局相关。未来的研究应在合并症更多的老年队列中检查类似结局，以进一步减少一般健康状况与晚年症状缺乏之间的潜在混杂因素。
