RT Journal Article
SR Electronic
T1 Examining later-in-life health risks associated with sport-related concussion and repetitive head impacts: a systematic review of case-control and cohort studies
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 810
OP 824
DO 10.1136/bjsports-2023-106890
VO 57
IS 12
A1 Iverson, Grant L
A1 Castellani, Rudolph J
A1 Cassidy, J David
A1 Schneider, Geoff M
A1 Schneider, Kathryn J
A1 Echemendia, Ruben J
A1 Bailes, Julian E
A1 Hayden, K Alix
A1 Koerte, Inga K
A1 Manley, Geoffrey T
A1 McNamee, Michael
A1 Patricios, Jon S
A1 Tator, Charles H
A1 Cantu, Robert C
A1 Dvorak, Jiri
YR 2023
UL http://bjsm.bmj.com/content/57/12/810.abstract
AB Objective Concern exists about possible problems with later-in-life brain health, such as cognitive impairment, mental health problems and neurological diseases, in former athletes. We examined the future risk for adverse health effects associated with sport-related concussion, or exposure to repetitive head impacts, in former athletes.Design Systematic review.Data sources Search of MEDLINE, Embase, Cochrane, CINAHL Plus and SPORTDiscus in October 2019 and updated in March 2022.Eligibility criteria Studies measuring future risk (cohort studies) or approximating that risk (case-control studies).Results Ten studies of former amateur athletes and 18 studies of former professional athletes were included. No postmortem neuropathology studies or neuroimaging studies met criteria for inclusion. Depression was examined in five studies in former amateur athletes, none identifying an increased risk. Nine studies examined suicidality or suicide as a manner of death, and none found an association with increased risk. Some studies comparing professional athletes with the general population reported associations between sports participation and dementia or amyotrophic lateral sclerosis (ALS) as a cause of death. Most did not control for potential confounding factors (eg, genetic, demographic, health-related or environmental), were ecological in design and had high risk of bias.Conclusion Evidence does not support an increased risk of mental health or neurological diseases in former amateur athletes with exposure to repetitive head impacts. Some studies in former professional athletes suggest an increased risk of neurological disorders such as ALS and dementia; these findings need to be confirmed in higher quality studies with better control of confounding factors.PROSPERO registration number CRD42022159486.All data relevant to the study are included in the article or uploaded as supplementary information.