A - 14 Stability of Cognitive and Neurobehavioral Symptom Endorsement in Older Former NFL Players and Influential Factors

Abstract Purpose To investigate the stability of cognitive and neurobehavioral symptoms over time in former professional football players; characterize impairment and change rates; examine factors associated with symptom endorsement changes. Method Former players (N = 219; M = 57.7(SD = 6.1) years of age) completed a health questionnaire including self-rated measures of cognition (PROMIS Cognitive-SF) and executive function (Neuro-QoL Emotional and Behavioral Dyscontrol-SF) at two timepoints (time between M = 23.7(SD = 14.4) months). Descriptive statistics characterized impairment and change rate proportions. Correlations (controlling for time between visits) and ANOVA examined associations of a priori factors and symptom endorsement change (T-score difference). Results Symptom endorsement was stable for cognition (r = 0.66, p < 0.001) and executive function (r = 0.66, p < 0.001). Similar proportions of individuals were >/=1SD beyond the mean toward impairment at Time-1 (cognition = 25.1%; executive dysfunction = 16.4%) and Time-2 (cognition = 27.0%; executive dysfunction = 16.7%). The greatest proportion of individuals were within normal limits at Time-1 and remained so at Time-2 (cognition = 65.3%; executive dysfunction = 74.6%), though improvement and decline were also observed (cognition improvement = 7.7%, decline = 9.6%; executive dysfunction improvement = 8.7%, decline = 8.9%). Higher depression and pain interference symptoms and lower education and self-efficacy at Time-1 were significantly associated with improvement in cognitive and executive function symptoms (r = |0.15–0.36|, p = 0.025- <0.001). Greater concussion history was associated with improved cognition ratings, P = 0.22, p = 0.001. Conclusions Cognitive and neurobehavioral symptoms remain generally stable over time in older former football players, though a notable proportion experience change in both directions. Worse clinical functioning in multiple domains at Time-1 was associated with greater improvement in symptoms over time, suggesting opportunities for potential improvement in cognitive symptoms in those experiencing difficulties.