Association of Playing College American Football With Long-term Health Outcomes and Mortality.
Association of Playing College American Football With Long-term Health Outcomes and Mortality.
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长期健康成果和死亡率的大学美式足球协会。
DOI：
10.1001/jamanetworkopen.2022.8775
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发表时间：
2022-04-01
影响因子：
13.8
通讯作者：
Stern, Robert A.
中科院分区：
文献类型：
--
作者：
Phelps, Alyssa;Alosco, Michael L.;Baucom, Zachary;Hartlage, Kaitlin;Palmisano, Joseph N.;Weuve, Jennifer;Mez, Jesse;Tripodis, Yorghos;Stern, Robert A.
这项队列研究比较了前大学橄榄球运动员自我报告的健康状况的患病率与普通人群中男性的患病率，以及前大学橄榄球运动员与美国普通男性人群的标准化死亡率。在一组年龄较大的前大学橄榄球运动员中，自我报告的健康状况和死亡率的患病率是多少？在这项对447名年龄在59岁至75岁之间的前大学橄榄球运动员的队列研究中，与普通人群中的男性匹配样本相比，完成调查的前在世运动员的认知障碍，复发性头痛，心血管疾病和高胆固醇血症的患病率显着较高，但糖尿病的患病率较低。尽管所有前运动员的总体死亡率明显低于美国普通男性人口，但脑癌和其他神经系统癌症的死亡率较高。研究结果表明，需要进行额外的研究，为利益相关者提供指导，以最大限度地利用改善健康结果的因素，并消除或减少可能增加晚年发病率和死亡率风险的因素。暴露于橄榄球运动中的反复头部撞击（包括导致症状性脑震荡和亚脑震荡创伤的撞击）与晚年健康问题的风险增加有关，包括认知和神经精神衰退以及神经退行性疾病。大多数关于踢足球对健康的长期影响的研究都集中在前职业运动员身上，对前大学运动员的研究有限。评估前大学橄榄球运动员自我报告的健康状况的患病率，并与普通人群中的男性样本进行比较，以及前大学橄榄球运动员的标准化死亡率（SMR）。这项队列研究包括447名前圣母大学（ND）足球运动员的数据，年龄在59至75岁之间，他们是1964年至1980年名册上的老年人。一项健康结果调查分发给在世的球员和已故球员的近亲，他们的联系信息是可用的。调查于二零一八年十二月至二零一九年五月期间完成。在ND参加足球比赛。健康结果的患病率在完成调查的在世前球员和健康与退休研究（HRS）中的倾向评分匹配的参与者之间进行了比较。所有前运动员的所有原因和特定原因的标准化死亡率与美国普通人群中的男性进行了比较。共有216名在世球员完成了健康调查（中位年龄67岁; IQR，63-70岁），并与HRS的638名参与者（中位年龄66岁; IQR，63-70岁）进行了比较。前运动员报告认知障碍的患病率更高（10 [5%] vs 8 [1%]; P = .02），头痛（22 [10%] vs 22 [4%]; P = .001），心血管疾病（70 [33%] vs 128 [20%]; P = .001），高胆固醇血症（111 [52%] vs 182 [29%]; P = .001），（185 [86%] vs 489 [77%]; P = 0.02）和糖尿病患病率较低（24 [11%] vs 146 [23%]; P = 0.001）。全因死亡率（SMR，0.54; 95% CI，0.42-0.67）和心脏死亡率（SMR，0.64; 95% CI，0.39-0.99），循环（SMR，0.23; 95% CI，0.03-0.83），呼吸道（SMR，0.13; 95% CI，0.00-0.70），消化系统（SMR，0.13; 95% CI，0.00-0.74）疾病;肺癌ND组人群中的性暴力（SMR，0.26; 95% CI，0.05-0.77）和暴力（SMR，0.10; 95% CI，0.00-0.58）显著低于普通人群。ND队列中脑和其他神经系统癌症的死亡率显著较高（SMR，3.82; 95% CI，1.04-9.77）。尽管所有神经退行性疾病（SMR，1.42; 95% CI，0.29-4.18）、肌萎缩侧索硬化症（SMR，2.93; 95% CI，0.36-10.59）和帕金森病（SMR，2.07; 95% CI，0.05-11.55）的点估计值更大，但差异未达到统计学显著性。在这项对前大学足球运动员的队列研究中，观察到了积极和消极的健康结果。由于有超过80万名前大学球员居住在美国，因此似乎需要进行更多的研究，为利益相关者提供指导，以最大限度地提高改善健康结果的因素，并最大限度地减少可能增加晚年发病率和死亡率风险的因素。
This cohort study compares the prevalence of self-reported health conditions among former college football players with that in a sample of men in the general population as well as standardized mortality ratios among the former college football players with those in the general US population of men. What were the prevalence of self-reported health conditions and mortality rate in a cohort of older former college American football players? In this cohort study of 447 former college football players aged 59 to 75 years, compared with a matched sample of men in the general population, former living players who completed a survey had a significantly higher prevalence of cognitive impairment disorders, recurrent headaches, cardiovascular disease, and hypercholesterolemia but a lower prevalence of diabetes. Although overall mortality among all former players was significantly lower than that in the general US male population, mortality from brain and other nervous system cancers was higher. The findings suggest that additional research is needed to provide stakeholders with guidance to maximize factors that improve health outcomes and eliminate or reduce factors that may increase risk for later-life morbidity and mortality. Exposure to repetitive head impacts from playing American football (including impacts resulting in symptomatic concussions and subconcussive trauma) is associated with increased risk for later-life health problems, including cognitive and neuropsychiatric decline and neurodegenerative disease. Most research on long-term health consequences of playing football has focused on former professional athletes, with limited studies of former college players. To estimate the prevalence of self-reported health conditions among former college football players compared with a sample of men in the general population as well as standardized mortality ratios (SMRs) among former college football players. This cohort study included data from 447 former University of Notre Dame (ND) football players aged 59 to 75 years who were seniors on the rosters from 1964 to 1980. A health outcomes survey was distributed to living players and next of kin of deceased players for whom contact information was available. The survey was completed from December 2018 to May 2019. Participation in football at ND. Prevalence of health outcomes was compared between living former players who completed the survey and propensity score–matched participants in the Health and Retirement Study (HRS). Standardized mortality ratios of all causes and specific causes of death among all former players were compared with those among men in the general US population. A total of 216 living players completed the health survey (median age, 67 years; IQR, 63-70 years) and were compared with 638 participants in the HRS (median age, 66 years; IQR, 63-70 years). Former players reported a higher prevalence of cognitive impairment (10 [5%] vs 8 [1%]; P = .02), headaches (22 [10%] vs 22 [4%]; P = .001), cardiovascular disease (70 [33%] vs 128 [20%]; P = .001), hypercholesterolemia (111 [52%] vs 182 [29%]; P = .001), and alcohol use (185 [86%] vs 489 [77%]; P = .02) and a lower prevalence of diabetes (24 [11%] vs 146 [23%]; P = .001). All-cause mortality (SMR, 0.54; 95% CI, 0.42-0.67) and mortality from heart (SMR, 0.64; 95% CI, 0.39-0.99), circulatory (SMR, 0.23; 95% CI, 0.03-0.83), respiratory (SMR, 0.13; 95% CI, 0.00-0.70), and digestive system (SMR, 0.13; 95% CI, 0.00-0.74) disorders; lung cancer (SMR, 0.26; 95% CI, 0.05-0.77); and violence (SMR, 0.10; 95% CI, 0.00-0.58) were significantly lower in the ND cohort than in the general population. Mortality from brain and other nervous system cancers was significantly higher in the ND cohort (SMR, 3.82; 95% CI, 1.04-9.77). Whereas point estimates were greater for all neurodegenerative causes (SMR, 1.42; 95% CI, 0.29-4.18), amyotrophic lateral sclerosis (SMR, 2.93; 95% CI, 0.36-10.59), and Parkinson disease (SMR, 2.07; 95% CI, 0.05-11.55), the difference did not reach statistical significance. In this cohort study of former college football players, both positive and negative health outcomes were observed. With more than 800 000 former college players living in the US, additional research appears to be needed to provide stakeholders with guidance to maximize factors that improve health outcomes and minimize factors that may increase risk for later-life morbidity and mortality.
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DOI：
10.1016/j.jalz.2018.05.004
发表时间：
2018-09
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
Alosco ML;Tripodis Y;Fritts NG;Heslegrave A;Baugh CM;Conneely S;Mariani M;Martin BM;Frank S;Mez J;Stein TD;Cantu RC;McKee AC;Shaw LM;Trojanowski JQ;Blennow K;Zetterberg H;Stern RA
通讯作者：
Stern RA
影响因子：
4.8
作者：
Guskiewicz, KM;Marshall, SW;Jordan, BD
通讯作者：
Jordan, BD
影响因子：
2.7
作者：
Adler, Caleb M.;DelBello, Melissa P.;Divine, Jon
通讯作者：
Divine, Jon
影响因子：
2.3
作者：
Hinton, Pamela S.;Johnstone, Brick;Bodling, Angela
通讯作者：
Bodling, Angela
影响因子：
--
作者：
Ehrlich, Justin;Kmush, Brittany;Sanders, Shane
通讯作者：
Sanders, Shane