Does Age of Exposure to Tackle Football Affect CTE Severity?

Onset of Cognitive, Behavioral, and Mood Symptoms

Of the 211 participants with CTE, 183 developed cognitive and behavioral or mood symptoms prior to death, eight had only cognitive symptoms, 12 had only behavioral or mood symptoms, and seven did not endorse any symptoms examined in the study. Clinical data for one participant were not available.

Among tackle football players with CTE, every one year younger that they began to play tackle football predicted earlier onset of cognitive symptoms by 2.44 years and of behavioral or mood symptoms by 2.50 years. Exposure before age 12 predicted earlier cognitive and behavioral or mood symptom onset by 13.39 years and 13.28 years, respectively.

Secondary subset analyses indicated that younger age of exposure to tackle football was associated with earlier onset of functional impairment in participants who were determined to have had dementia. Researchers observed nearly identical effects in participants with CTE only.

Study limitations include the lack of an appropriate control or comparison group, the researchers noted. In addition, the results may not be generalizable to a broader tackle football population.

“Given the growing public health concerns for participation in tackle football, prospective studies of former tackle football players that include objective clinical assessments are needed to better understand the relationship between youth tackle football exposure and long-term neurobehavioral outcomes,” said the researchers.

“More research on this topic is needed before any clinical recommendations, as well as recommendations on policy or rule changes, can be made,” said Dr. Alosco.

“Boston University and sites across the country are currently conducting longitudinal studies on former football players, which will allow us to begin to study cognition and behavior and mood functioning over time.”

—Erica Tricarico

Suggested Reading

Alosco ML, Mez J, Tripodis Y, et al. Age of first exposure to tackle football and chronic traumatic encephalopathy. Ann Neurol. 2018 Apr 30 [Epub ahead of print].