Neurological Health In Former Amateur Ice Hockey Players: Considerations For Lifestyle Factors And Career Duration

Repetitive head impacts (RHI) are common in contact sports like ice hockey and may increase the risk of later-life neurodegenerative disorders, cognitive impairment, and mental health decline. The Lifestyle for Brain Health (LIBRA) score quantifies modifiable lifestyle risk factors potentially linked to cognitive and functional decline. While LIBRA has predicted cognitive function and mild cognitive impairment in former professional football players, its use in predicting these outcomes among former amateur ice hockey players remains unexplored. PURPOSE: Evaluate the impact of RHI exposure and lifestyle factors on later-life neurological health in former ice hockey players. METHODS: 52 former ice hockey players (age: 54.1 ± 14.4 y.o., career duration: 26.3 ± 15.7 yrs.) completed an online questionnaire, including demographics, sports participation history, and health history. Mental health was evaluated using the Apathy Evaluation Scale (AES) and Center for Epidemiological Studies Depression Scale (CES-D); cognitive function was measured via the PROMIS Cognitive Function Short Form 4a (PROMIS CF). LIBRA scores were calculated as in prior studies, with higher scores indicating greater risk (range = -5.9 - 14.6). Career duration was based on self-reported start and end ages. Linear regressions assessed LIBRA scores and career duration associations with mental health and cognitive outcomes. RESULTS: LIBRA scores (-0.8 ± 2.4) were significantly associated with AES (28.4 ± 6.6, R2 = 0.14, ß = 0.38, p = 0.006) and CES-D (8.8 ± 6.4, R2 = 0.20, ß = 0.45, p = 0.002) scores, indicating worse mental health with higher LIBRA scores. Career duration showed no significant associations with AES (R2 = 0.01, ß = 0.10, p = 0.503) or CES-D (R2 = 0.02, ß = -0.15, p = 0.307), but longer career duration was significantly linked to higher (worse) PROMIS CF T scores (52.1 ± 7.9, R2 = 0.12, ß = 0.34, p = 0.014). No association was observed between LIBRA scores and cognitive function (R2 = 0.04, ß = -0.19, p = 0.181). CONCLUSION: Consistent with recent retired football player studies, LIBRA scores were associated with poorer mental health, but not with cognitive function or career duration. These findings underscore the importance of targeting modifiable lifestyle factors to support long-term health in individuals with prior RHI exposure.