Football concussions linked to long-term cognitive problems

March 10, 2023 – Eric Washington, a former linebacker for the University of Kansas football team, has been involved in sports since childhood. “We bumped into each other when we played and whoever was the strongest or the most reckless was thought to have the best sporting career ahead of them,” he says.

He and his friends boxed and played soccer on each other’s lawns “with no equipment or protection, just a lot of guys bumping into each other.”

In high school, Washington became a successful football player. “You had to show people you weren’t afraid, so you took on bigger … guys and ran with them,” he recalls. “I became one of those fearless people known as ‘that guy’ – hard-hitting, relentless, reckless.”

Washington’s first serious brain injury occurred in the ninth grade. “It was the first head-on collision that knocked me out and I missed a lot of ninth grade because of it,” he says. “I went from being a quiet, withdrawn, mild-mannered person to being aggressive, having mood swings and freaking out.”

He developed memory and concentration problems that worsened when he started college football. “I remember two or three times when I passed out after a head injury and was taken out, but then I was right back in the game,” he says.

Like Washington, many athletes suffer brain injuries during their careersBetween 1.6 and 3 million sports and leisure-related concussions takes place every year and around 300,000 of those come from football.

Cognitive changes following a concussion are also common. THE a new study published in Archives of Clinical Neuropsychology highlights the problem.

For Washington, concussions and their effects continued in college. While I was on a football scholarship at Kansas, “I thought everything was fine. Even after my concussions, I was able to return to the game and my body retained its “muscle memory” of how to play football and was able to follow instructions even when my mind was no longer there.

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During his senior year, a neck and spine injury ended his sports career. “After that, it all went downhill,” he says. “I was in terrible relationships, away from my family and even homeless for a while. I ended up in mental institutions, dark places and with cognitive problems.”

Does concussion affect long-term cognitive functioning?

In the new study, investigators looked at 353 former NFL players (average age, 54) who had retired nearly 3 decades ago.

Using a laptop or tablet, the former players took a series of neuropsychological tests through an online platform called TestMyBrain. A range of cognitive functions were tested, including processing speed, visuospatial and working memory, short- and long-term memory, and vocabulary.

The players completed a 76-question questionnaire that included 10 questions about the signs and symptoms of concussion following a hit to the head during football: headache, nausea, dizziness, loss of consciousness, memory problems, disorientation, confusion, seizures, vision problems, or feeling unsteady on your feet. They were also asked if they had ever been diagnosed with a concussion.

According to the study’s lead author, Laura Germine, PhD, director of the Brain and Cognitive Health Technology Laboratory at McLean Hospital in Boston, we know the impact of concussions on short-term health, but “it’s not as clear how a history of concussion affects cognitive function over the longer term.” among former professional footballers.”

He says, “there have been a lot of mixed results in former players, so we wanted to address this question with sensitive, state-of-the-art, and objective measures of cognitive function in a larger sample of former players than previously tested. this kind of study.”

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One reason for the “mixed findings” in previous research is that some studies focused on diagnosed concussions and cognitive problems. However, many football players end up going undiagnosed with concussions, so the researchers decided to look specifically at concussion symptoms.

Accelerated cognitive aging

Former players who reported more concussion symptoms performed worse on cognitive tests. For example, the differences in visual memory between the players with the highest and lowest concussion symptoms equaled the difference in cognitive performance between a typical 35-year-old and a typical 60-year-old.

On the other hand, poorer cognitive performance was not related to the number of diagnosed concussions, the number of years spent in professional football, or the number of years the freshmen played football.

The researchers conducted a follow-up study comparing the 353 players with 5,086 men who did not play football. They found that cognitive performance was generally worse for former players

“Although our results are inconclusive in this regard, we found the largest differences in cognitive performance (compared to men of similar age) among older players,” says Germine.

Long-term cognitive problems

Washington continues to struggle with cognitive issues.

“My long-term memory sometimes seems intact, but after a while there are ‘holes’. Or I look at people and maybe recognize a face, but I can’t remember who they are.

He also has difficulty with reading and memory. “My eyes have problems tracking and tracking. And if I read out loud, I will stutter and not be able to retain what I just read. Sometimes I put the remote in the freezer or leave my phone outside and I don’t know where it is.”

Washington graduated from college with a bachelor’s degree in applied behavioral science, which led to his work with adults with developmental disabilities. However, school work was difficult and had become even more difficult lately.

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“I want to be a social worker to help others, but I might not want to go through my classes,” she says.

He is currently being treated for cancer and chemotherapy is also affecting his cognition. “In one course, I got an A on my class work, but I didn’t remember anything about the final, so I got an F and failed the course,” she says.

He hopes to try his studies again once the cancer is gone. Although the cognitive challenges from the concussion are still enormous, “not having chemo brain frees up some cognitive abilities and hopefully I can do better in my classes and get my social work degree.”

Get the right support

Germine said the study results “underscore the need for parents, the school system and everyone who plays football to understand the importance of reporting any concussion symptoms, even if they don’t feel serious at the time.”

He notes that “appropriate measures to manage and reduce the effects of head injuries, even in the absence of diagnosed concussions, may be key to maintaining long-term cognitive health.”

Additionally, “we must do everything we can to prevent head injuries and concussions. “Measures that reduce the likelihood of head impacts are important to making football safer for the developing brain,” he says.

Washington urges people to take head injuries seriously and not just “get back in the game” and be evaluated for concussions; and if a concussion is diagnosed, to treat the symptoms (such as emotional trauma, attention or memory problems, or vision problems).

In addition, both encourage people with concussions to get emotional support. Washington participates in the support groups it offers Brain Injury Association of America.