Associations Between Head Trauma Exposures, Mental Health, And Cognitive Health Following A Collegiate Athletic Career

Exposure to head trauma has raised concerns about long-term health outcomes for National Collegiate Athletic Association (NCAA) athletes, but the intermediate effects after their collegiate career are relatively unknown. PURPOSE: To evaluate the association between head trauma exposure and mental/cognitive health outcomes among former NCAA athletes. METHODS: Athletes (n = 3783; 51% male, 75% White, 64% no concussion history) enrolled in the Concussion, Assessment, Research and Education (CARE) Consortium study from 2014-2021 and were later evaluated <6 years of leaving college. Athletes completed demographic forms evaluating head trauma exposures of: concussion history, sport exposure, and total years of sport participation. Athletes completed the 9-item Patient Health Questionnaire (PHQ-9; depressive symptoms), 18-item Brief Symptom Inventory (BSI-18; psychological symptoms), and 8-item Neuro-Quality of Life cognitive domain (NQoL; cognitive function). Medians (interquartile range; IQR) were used to describe outcomes. Separate multivariable negative binomial regression models assessed associations between PHQ-9, BSI-18, and NQoL total scores with head trauma exposures, adjusting for sex and race. Score ratios (SR) with 95% confidence intervals (95% CI) not crossing 1.00 were statistically significant. RESULTS: The overall median (IQR) for PHQ-9 was 2.0 (5.0), BSI-18 was 3.0 (8.0), and NQoL was 35.0 (32.0). Concussion history was associated with worse PHQ-9, BSI-18, and NQoL total scores (Table). Only high sport exposure associated with PHQ-9, but no other outcome. Years of sport participation was not associated with any outcome. CONCLUSIONS: Concussion history was consistently associated with worse mental and cognitive health outcomes, while sport exposure and total years of sport participation overall were not. Our findings provide insights to focal head trauma exposure measures for researchers and clinicians to consider.Supported by NCAA and DoD Award# W81XWH-14-2-0151.