Former college athletes who experienced three or more concussions reported slightly worse physical, mental, behavioral, and cognitive health five years after graduation, according to a March 11 article published in Neurology, the medical journal of the American Academy of Neurology.
The study is significant as it examines the long-term effects of repeated concussions on young adults who participated in collegiate sports. Understanding these outcomes can help inform future policies and support services for student-athletes.
Researchers studied 3,910 former college athletes from 20 different sports, nearly half of whom were female. Most participants played at National Collegiate Athletic Association Division 1 schools. All had baseline concussion evaluations before starting their college sport and were reassessed within five years after graduation. During both assessments, athletes reported their concussion history and completed various medical questionnaires and tests measuring concussion symptoms.
Participants were grouped by concussion history: zero, one to two, or three or more concussions. Those with three or more concussions averaged five concussion-related symptoms compared to three symptoms among those with no concussions. After adjusting for factors such as pain interference in daily life, researchers found that athletes with three or more concussions scored worse than those with none on seven measures including anxiety, depression, psychological distress, sleep quality, concussion-related symptoms, and overall health and well-being. Athletes with one to two concussions also showed worse scores than those without any history of concussion on several tests.
"While the effect sizes of our findings are quite small, the study participants are still young adults in their 20s, so we don't know if or how these effects might change throughout their lives," said Broglio. "It is also important to note that despite the associations, the vast majority of athletes remained within normal clinical levels for brain health. Continuing to follow these athletes may help determine if these associations become more or less apparent and meaningful over time."
A limitation noted by researchers was that most participants were white people (76%), which may affect whether results apply broadly across other races and ethnicities. The study received support from the NCAA and the Department of Defense.
