4.6 Article

Health-promoting behaviours and concussion history are associated with cognitive function, mood-related symptoms and emotional-behavioural dyscontrol in former NFL players: an NFL-LONG Study

Journal

BRITISH JOURNAL OF SPORTS MEDICINE
Volume 55, Issue 12, Pages 683-+

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bjsports-2020-103400

Keywords

concussion; american football; diet; exercise; Sleep

Categories

Funding

  1. National Football League
  2. Boston Children's Hospital

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In former NFL players, self-reported sport-related concussion (SRC) history is associated with current health-promoting behaviors and self-reported measures of brain health. The study found that SRC history is linked to poorer cognitive function, symptoms of depression and anxiety, and emotional-behavioral dyscontrol, while exercise frequency and diet quality are associated with better functioning, and sleeping less than 6 hours per night is related to worse mental health outcomes.
Objectives To examine the relationships among self-reported sport-related concussion (SRC) history and current health-promoting behaviours (exercise frequency, diet quality and sleep duration) with self-reported measures of brain health (cognitive function, symptoms of depression and anxiety and emotional-behavioural dyscontrol) in former NFL players. Methods In this cross-sectional study, a questionnaire was sent to former NFL players. Respondents reported SRC history (categorical: 0; 1-2; 3-5; 6-9; 10+ concussions), number of moderate-to-vigorous aerobic and resistance exercise sessions per week, diet quality (Rapid Eating Assessment for Participants-Shortened) and average nightly sleep duration. Outcomes were Patient-Reported Outcomes Measurement Information System Cognitive Function, Depression, and Anxiety, and Neuro-QoL Emotional-Behavioral Dyscontrol domain T-scores. Multivariable linear regression models were fit for each outcome with SRC history, exercise frequency, diet quality and sleep duration as explanatory variables alongside select covariates. Results Multivariable regression models (n=1784) explained approximately 33%-38% of the variance in each outcome. For all outcomes, SRC history (0.144 <=|beta|<= 0.217) was associated with poorer functioning, while exercise frequency (0.064 <=|beta|<= 0.088) and diet quality (0.057 <=|beta|<= 0.086) were associated with better functioning. Sleeping under 6 hours per night (0.061 <=|beta|<= 0.093) was associated with worse depressive symptoms, anxiety and emotional-behavioural dyscontrol. Conclusion Several variables appear to be associated with mood and perceived cognitive function in former NFL players. SRC history is non-modifiable in former athletes; however, the effects of increasing postplaying career exercise frequency, making dietary improvements, and obtaining adequate sleep represent important potential opportunities for preventative and therapeutic interventions.

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