Association between recurrent concussion and late-life cognitive impairment in retired professional football players

被引:845
作者
Guskiewicz, KM
Marshall, SW
Bailes, J
McCrea, M
Cantu, RC
Randolph, C
Jordan, BD
机构
[1] Univ N Carolina, Sports Med Res Lab, Dept Exercise & Sport Sci, Chapel Hill, NC 27599 USA
[2] Univ N Carolina, Dept Orthoped, Chapel Hill, NC 27599 USA
[3] Univ N Carolina, Dept Epidemiol & Orthoped, Chapel Hill, NC 27599 USA
[4] W Virginia Univ, Dept Neurosurg, Sch Med, Morgantown, WV 26506 USA
[5] Med Coll Wisconsin, Dept Neurol, Milwaukee, WI 53226 USA
[6] Waukesha Mem Hosp, Ctr Neurosci, Waukesha, WI USA
[7] Brigham & Womens Hosp, Neurol Sports Injury Ctr, Boston, MA 02115 USA
[8] Emerson Hosp, Neurosurg Serv, Concord, MA USA
[9] Loyola Univ, Sch Med, Dept Neurol, Maywood, IL 60153 USA
[10] Chicago Neurol Inst, Chicago, IL USA
[11] Burke Rehabil Hosp, Memory Evaluat & Treatment Serv, White Plains, NY USA
关键词
Alzheimer; concussion; mild cognitive impairment; retired professional football players;
D O I
10.1227/01.NEU.0000175725.75780.DD
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: Cerebral concussion is common in collision sports such as football, yet the chronic neurological effects of recurrent concussion are not well understood. The purpose of our study was to investigate the association between previous head injury and the likelihood of developing mild cognitive impairment (MCI) and Alzheimer's disease in a unique group of retired professional football players with previous head injury exposure. METHODS: A general health questionnaire was completed by 2552 retired professional football players with an average age of 53.8 (13.4) years and an average professional football playing career of 6.6 ( +/- 3.6) years. A second questionnaire focusing on memory and issues related to MCI was then completed by a subset of 758 retired professional football players ( >= 50 yr of age). Results on MCI were then cross-tabulated with results from the original health questionnaire for this subset of older retirees. RESULTS: Of the former players, 61% sustained at least one concussion during their professional football career, and 24% sustained three or more concussions. Statistical analysis of the data identified an association between recurrent concussion and clinically diagnosed MCI (chi(2) = 7.82, df = 2, P = 0.02) and self-reported significant memory impairments (chi(2) = 19.75, df = 2, P = 0.001). Retired players with three or more reported concussions had a fivefold prevalence of MCI diagnosis and a threefold prevalence of reported significant memory problems compared with retirees without a history of concussion. Although there was not an association between recurrent concussion and Alzheimer's disease, we observed an earlier onset of Alzheimer's disease in the retirees than in the general American male population. CONCLUSION: Our findings suggest that the onset of dementia-related syndromes may be initiated by repetitive cerebral concussions in professional football players.
引用
收藏
页码:719 / 724
页数:6
相关论文
共 41 条
[1]   A CASE-CONTROL STUDY OF ALZHEIMERS-DISEASE IN AUSTRALIA [J].
BROE, GA ;
HENDERSON, AS ;
CREASEY, H ;
MCCUSKER, E ;
KORTEN, AE ;
JORM, AF ;
LONGLEY, W ;
ANTHONY, JC .
NEUROLOGY, 1990, 40 (11) :1698-1707
[2]   Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset [J].
Brookmeyer, R ;
Gray, S ;
Kawas, C .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1998, 88 (09) :1337-1342
[3]   HEAD TRAUMA WITH LOSS OF CONSCIOUSNESS AS A RISK FACTOR FOR ALZHEIMERS-DISEASE [J].
CHANDRA, V ;
KOKMEN, E ;
SCHOENBERG, BS ;
BEARD, CM .
NEUROLOGY, 1989, 39 (12) :1576-1578
[4]   Cumulative effects of concussion in high school athletes [J].
Collins, MW ;
Lovell, MR ;
Iverson, GL ;
Cantu, RC ;
Maroon, JC ;
Field, M .
NEUROSURGERY, 2002, 51 (05) :1175-1179
[5]   Predicting conversion to Alzheimer disease using standardized clinical information [J].
Daly, E ;
Zaitchik, D ;
Copeland, M ;
Schmahmann, J ;
Gunther, J ;
Albert, M .
ARCHIVES OF NEUROLOGY, 2000, 57 (05) :675-680
[6]   CLINICAL AND EPIDEMIOLOGIC ASPECTS OF ALZHEIMERS-DISEASE WITH PRESENILE ONSET - A CASE CONTROL STUDY [J].
FERINISTRAMBI, L ;
SMIRNE, S ;
GARANCINI, P ;
PINTO, P ;
FRANCESCHI, M .
NEUROEPIDEMIOLOGY, 1990, 9 (01) :39-49
[7]   RISK-FACTORS FOR LATE-ONSET ALZHEIMERS-DISEASE - A POPULATION-BASED, CASE-CONTROL STUDY [J].
FRATIGLIONI, L ;
AHLBOM, A ;
VIITANEN, M ;
WINBLAD, B .
ANNALS OF NEUROLOGY, 1993, 33 (03) :258-266
[8]   THE ASSOCIATION BETWEEN HEAD TRAUMA AND ALZHEIMERS-DISEASE [J].
GRAVES, AB ;
WHITE, E ;
KOEPSELL, TD ;
REIFLER, BV ;
VANBELLE, G ;
LARSON, EB ;
RASKIND, M .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1990, 131 (03) :491-501
[9]   Head injury and the risk of AD in the MIRAGE study [J].
Guo, Z ;
Cupples, LA ;
Kurz, A ;
Auerbach, SH ;
Volicer, L ;
Chui, H ;
Green, RC ;
Sadovnick, AD ;
Duara, R ;
DeCarli, C ;
Johnson, K ;
Go, RC ;
Growdon, JH ;
Haines, JL ;
Kukull, WA ;
Farrer, LA .
NEUROLOGY, 2000, 54 (06) :1316-1323
[10]   Cumulative effects associated with recurrent concussion in collegiate football players - The NCAA Concussion Study [J].
Guskiewicz, KM ;
McCrea, M ;
Marshall, SW ;
Cantu, RC ;
Randolph, C ;
Barr, W ;
Onate, JA ;
Kelly, JP .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 290 (19) :2549-2555