Association of Playing High School Football With Cognition and Mental Health Later in Life
Association of Playing High School Football With Cognition and Mental Health Later in Life
复制标题
DOI：
10.1001/jamaneurol.2017.1317
复制
发表时间：
2017-08-01
期刊：
影响因子：
29
通讯作者：
Small, Dylan S.
中科院分区：
文献类型：
--
作者：
Deshpande, Sameer K.;Hasegawa, Raiden B.;Small, Dylan S.
美式橄榄球是美国高中参与人数最多的运动，也是青少年脑震荡的主要原因。在高中阶段暴露于与足球相关的头部创伤对认知和心理健康的长期影响知之甚少。目的评估在65岁时踢高中橄榄球与认知障碍和抑郁的关系。设计、设置和参与者对1957年威斯康星州高中毕业的具有代表性的高中生进行了研究。在这项使用威斯康星州纵向研究数据的队列研究中，足球运动员在2017年3月1日至7月1日期间被匹配，并与几个基线协变量进行对照，如青少年智商、家庭背景和教育水平。在稳健性方面，考虑了3种控制条件：所有控制者，参加无碰撞运动的人，以及不参加任何运动的人。EXPOSURES参加高中足球。MIN结果和测量根据65岁时进行的认知评估结果构建的关于语言流畅性和记忆力和注意力的综合认知测量。用改良的流行病学研究中心的抑郁量表评分来衡量抑郁。次要结果包括个人认知测试、愤怒、焦虑、敌意和酗酒的结果。结果在3904名男性(平均[SD]年龄，初次结果测量时为64.4[0.8]岁)中，经过配对和基于模型的协变量调整，与每种控制条件相比，踢足球与综合认知得分下降没有统计学上显著的有害关联(认知下降-0.04与所有对照组相比；97.5%CI，-0.14至0.05)或修改后的流行病学研究中心抑郁量表抑郁评分增加(-1.75比所有对照组降低；97.5%CI，-3.24至-0.26)。在调整了多项测试后，踢足球与任何次要结果都没有显著的不利关联，例如65岁时重度饮酒的可能性(优势比，0.68；95%可信区间，0.32-1.43)。从20世纪50年代中期开始，威斯康星州的高中橄榄球运动员和不踢球的高中足球运动员在以后的生活中发现，相关性认知和抑郁的结果是相似的。今天踢足球的风险可能与20世纪50年代不同，但对于现在的运动员来说，这项研究提供了关于今天参加运动的风险的信息，这些运动与20世纪50年代的高中橄榄球一样，具有类似的头部创伤风险。
IMPORTANCE American football is the largest participation sport in US high schools and is a leading cause of concussion among adolescents. Little is known about the long-term cognitive and mental health consequences of exposure to football-related head trauma at the high school level.OBJECTIVE To estimate the association of playing high school football with cognitive impairment and depression at 65 years of age.DESIGN, SETTING, AND PARTICIPANTS A representative sample of male high school students who graduated from high school in Wisconsin in 1957 was studied. In this cohort study using data from the Wisconsin Longitudinal Study, football players were matched between March 1 and July 1, 2017, with controls along several baseline covariates such as adolescent IQ, family background, and educational level. For robustness, 3 versions of the control condition were considered: all controls, those who played a noncollision sport, and those who did not play any sport.EXPOSURES Athletic participation in high school football.MAIN OUTCOMES AND MEASURES A composite cognition measure of verbal fluency and memory and attention constructed from results of cognitive assessments administered at 65 years of age. A modified Center for Epidemiological Studies' Depression Scale score was used to measure depression. Secondary outcomes include results of individual cognitive tests, anger, anxiety, hostility, and heavy use of alcohol.RESULTS Among the 3904 men (mean [SD] age, 64.4 [0.8] years at time of primary outcome measurement) in the study, after matching and model-based covariate adjustment, compared with each control condition, there was no statistically significant harmful association of playing football with a reduced composite cognition score (-0.04 reduction in cognition vs all controls; 97.5% CI, -0.14 to 0.05) or an increased modified Center for Epidemiological Studies' Depression Scale depression score (-1.75 reduction vs all controls; 97.5% CI, -3.24 to -0.26). After adjustment for multiple testing, playing football did not have a significant adverse association with any of the secondary outcomes, such as the likelihood of heavy alcohol use at 65 years of age (odds ratio, 0.68; 95% CI, 0.32-1.43).CONCLUSIONS AND RELEVANCE Cognitive and depression outcomes later in life were found to be similar for high school football players and their nonplaying counterparts from mid-1950s in Wisconsin. The risks of playing football today might be different than in the 1950s, but for current athletes, this study provides information on the risk of playing sports today that have a similar risk of head trauma as high school football played in the 1950s.