Mental Health and Perceived Cognitive Decline in Former Elite Rugby League Players With Life Interference Due to Chronic Pain

OBJECTIVE: To examine associations between life interference due to pain, mental health symptoms, and perceived cognitive decline in former elite Australian rugby league players. DESIGN: Descriptive cross-sectional study. SETTING: In-person assessments conducted as part of the Former Athlete Brain Health Research Program. PARTICIPANTS: Two hundred twenty-nine male former elite rugby league players (mean age = 52.66 years, SD = 13.46, range = 29-89) completed all primary measures. Participants were selected based on prior elite-level rugby league participation. INDEPENDENT VARIABLE: Pain interference scores from the Brief Pain Inventory were used to categorize participants into typical and high pain interference groups, with the top 25% classified as high interference. MAIN OUTCOME MEASURES: Mental health symptoms (Depression, Anxiety and Stress Scale), resilience (Connor-Davidson Resilience Scale), perceived cognitive decline [informant questionnaire on cognitive decline in the elderly (IQCODE)], and alcohol use (Alcohol Use Disorders Identification Test). RESULTS: The high pain interference group reported significantly greater depression (g = -0.81), anxiety (g = -0.75), stress (g = -0.73), worse perceived cognitive functioning (g = -0.48), and lower resilience (g = 0.51). They were more likely to report a history of depression [43.9% vs 24.0%, odds ratios (OR) = 2.48], arthritis (59.6% vs 44.4%, OR = 1.85), headaches (43.9% vs 20.6%, OR = 3.01), and cognitive decline (IQCODE ≥ 3.38: 46.3% vs 21.2%, OR = 3.20). No significant correlations were found with age, education, or concussion history. CONCLUSIONS: Pain-related life interference is associated with worse mental health, perceived cognitive decline, and reduced resilience in former elite athletes. These findings support the need for holistic and targeted interventions.