Cognitive and Neuropsychiatric Function in Former American Football Players

ImportanceRepetitive head impacts (RHI) from American football have been associated with later-life cognitive and neuropsychiatric changes. Findings have been limited by small samples, focus on elite players, and lack of appropriate control groups.ObjectiveTo assess the association between American football participation and cognitive and neuropsychiatric function in men 40 years or older.Design, Setting, and ParticipantsIn this cross-sectional study, online data from male football players in the Head Impact 95% CI, −1.23 to 0.05; β = −0.15;P = .03), PALTEA (B = 0.31; 95% CI, 0.07-0.54; β = 0.18;P = .01), ECog (B = 0.11; 95% CI, 0.07-0.15; β = 0.38;P P P P= .04), BRI (B = 0.27; 95% CI, 0.16-0.37; adjustedP P= .003), and PALTEA (B = 0.03; 95% CI, 0.004-0.06; adjustedP= .04) scores.Conclusions and RelevanceIn this cross-sectional study of former American football players, prior American football participation was associated with worse later-life cognitive and neuropsychiatric function. These findings support a dose-response association with years and level of play, providing context to help clinicians and researchers assess the risk of symptoms among former players.