Age Of First Exposure To American Football Is Not Related To Clinical Outcomes In Former Athletes

American football participation is hypothesized to result in long-term neurological deficits through both concussive and non-concussive head impacts. Retrospective studies have placed particular attention on the age at which an athlete is first exposed (AFE) to the sport and later life declines. To date, there have been no prospective investigations of AFE and concussion history. PURPOSE: To evaluate the health of former collegiate American football athletes relative to the AFE and lifetime concussion history. METHODS: Former collegiate American football players (N = 679) drawn from the Concussion Assessment, Research, and Education Consortium studied between 2014-2021 comprised the sample. Participants completed an assessment battery within 5 years of departing their university. AFE to football was calculated by subtracting the reported years of sport participation from the age at departure from their university. Lifetime diagnosed concussions included the reported number of concussions prior to enrollment and incident concussions during the study period. Descriptive statistics (mean (standard deviation)) described explanatory variables. Independent multivariable binary logistic regression models examined odds of adverse assessment scores (i.e., Alcohol Use Disorders Identification Test >8, Brief Symptom Inventory 18 change score ≥ 3, Neurological Quality of Life t-score < 46, Patient Health Questionnaire 9 ≥ 10, Pittsburgh Sleep Quality Index ≥5, Short Form Health Survey 12 Mental component <50 and Physical component score < 50, and the Sport Concussion Assessment Tool (SCAT) symptom inventory change score > 10). Effect estimates with 95% Confidence Intervals excluding 1.0 were considered statistically significant. RESULTS: Participants (25.0 (1.7) years) reported 10.3 (3.6) years of football participation, and 0.7 (1.2) lifetime diagnosed concussions. AFE and lifetime concussion history were not associated with any outcome measure. CONCLUSION: These data indicate no associations between concussion history and the AFE to American football on behavioral, cognitive, sleep, or physical clinical assessments. While prior reports have suggested AFE is associated with early cognitive decline, this was not observed in our cohort of athletes up to 5 years following their college career. Supported by: National Collegiate Athletic Association and the Dept of Defense Combat Casualty Care Research Program Award No. W81XWH1420151 and W81XWH1820047