Faculty Collaboration Database

Cumulative Concussion and Odds of Stroke in Former National Football League Players. Stroke 2022 Jan;53(1):e5-e8

Date

11/30/2021

Pubmed ID

34839696

Pubmed Central ID

PMC8966617

DOI

10.1161/STROKEAHA.121.035607

Scopus ID

2-s2.0-85122389924 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

BACKGROUND AND PURPOSE: Postmortem and experimental studies indicate a potential association between repeated concussions and stroke risk in older contact sport athletes. We examined the relationship between concussion and stroke history in former National Football League players aged ≥50 years.

METHODS: Former professional football players aged ≥50 years who played ≥1 year in the National Football League were enrolled in the cross-sectional study. Indirect standardization was used to calculate overall and decade-specific standardized prevalence ratios. Logistic regression using Firth's bias reduction method examined the association between lifetime concussion history 0 (n=119; 12.2%), 1 to 2 (n=152; 15.5%), 3 to 5 (n=242; 24.7%), 6 to 9 (201; 20.5%), and 10+(n=265; 27.1%) and stroke. Adjusted odds ratios for stroke were calculated for concussion history groups, age, and coronary artery disease and/or myocardial infarction.

RESULTS: The 979 participants who met inclusion criteria had a mean age of 65.0±9.0 years (range, 50-99). The prevalence of stroke was 3.4% (n=33), significantly lower than expected based on rates of stroke in US men aged 50 and over (standardized prevalence ratio=0.56, Z= -4.56, P<0.001). Greater odds of stroke history were associated with concussion history (10+ versus 0, adjusted odds ratio [95% CI]=5.51 [1.61-28.95]), cardiovascular disease (adjusted odds ratio [95% CI]=2.24 [1.01-4.77]), and age (1-year-increase adjusted odds ratio [95% CI]=1.07 [1.02-1.11]).

CONCLUSIONS: The prevalence of stroke among former National Football League players aged ≥50 years was lower than the general population, with significantly increased risk among those with 10 or more prior concussions. Findings add to the evidence suggesting that traumatic brain injuries are associated with increased risk of stroke. Clinically, management of cardio- and cerebrovascular health may be pertinent to those with a history of multiple prior concussions.

Author List

Brett BL, Kerr ZY, Aggarwal NT, Chandran A, Mannix R, Walton S, DeFreese JD, Echemendia RJ, Guskiewicz KM, McCrea MA, Meehan WP 3rd

Authors

Benjamin Brett PhD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin
Michael McCrea PhD Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Athletes
Brain Concussion
Cross-Sectional Studies
Female
Football
Humans
Male
Middle Aged
Prevalence
Stroke