Contributors To Caregiver Burden, Depression, And Anxiety In The Partners Of Professional American-style Football Players

PURPOSE: American-style football (ASF) has been linked to chronic adverse health outcomes. The extent to which ASF careers impact players’ spouses’ caregiver burden, depression, and anxiety remains unexplored. METHODS: Family Experiences Managing Football Lives (FEM-FL) is a cross-sectional study developed under the Football Players Health Study at Harvard University. Eligible participants were partners of current and former professional ASF players who completed electronic surveys from 2021 to 2024. Data on age, race, family composition, income, employment status, caregiver help, personal health, marital satisfaction, player position, and number of relocations were collected. Participants were additionally asked whether they believed their partner had chronic traumatic encephalopathy (CTE). Multivariable models measured associations between established and ASF-specific risk factors and caregiver burden (ZBI-4), depression (PHQ-2), and anxiety (GAD-2). RESULTS: Among 172 partners of active and former professional ASF players, mean [SD] age was 48.0 [13.0], and 29.1% self-identified as Black. Models that controlled for established risk factors identified significant associations between increased marital satisfaction and reduced caregiver burden (β = -6.35; 95%CI = -7.93, -4.80; p < 0.0001), depression (β = -1.47; 95%CI = -1.97, -0.97; p < 0.0001) and anxiety (β-1.49; 95%CI = -2.10, -0.90; p < 0.0001). In models that adjusted for established risk factors and ASF-specific variables, poor health among the partners was associated with increased reported depression (β = 1.44; 95%CI = 0.73, 2.15; p < 0.0001) and anxiety (β = 1.87; 95%CI = 1.02,2.73; p < 0.0001). CTE concerns were associated with increased caregiver burden (β = 2.99; 95%CI = 1.89, 4.09; p < 0.0001) and increased reported anxiety (β = 0.46; 95%CI = 0.03,0.90; p = 0.04), but had no association with depression in adjusted models. CONCLUSIONS: Among partners of active and former professional ASF players, marital satisfaction, poor health, and concerns about CTE may play a role in caregiver burden and behavioral health. CTE concerns may represent a novel risk factor for caregivers of ASF players. Supported by: National Football League Players Association