Football concussions linked to long-term cognitive problems

March 10, 2023 — Eric Washington, a former football linebacker for the University of Kansas, developed a passion for sports as a child. “We bumped into each other when we played, and it was believed that whoever was the strongest or the most reckless had the best sports career ahead of him,” he says.

He and his friends boxed and played football on each other’s lawns “with no equipment or protection, just a lot of guys running into each other.”

In high school, Washington became a successful football player. “You had to show people that you weren’t afraid, so you took on the bigger… guys and ran into them,” he recalls. “I became one of those fearless people who were called “that guy” – a strong, ruthless, reckless person.”

Washington’s first major head injury occurred in ninth grade. “It was the first head-on collision that knocked me out and I missed most of ninth grade because of it,” he says. “I went from a quiet, reserved, gentle person to an aggressive person with mood swings and edgy behavior.”

He developed problems with memory and concentration, which worsened when he started playing football in college. “I remember two or three times when I was stunned after a head injury, and I was taken out of the game, but then I returned to the game again,” he says.

As in the case of Washington, many athletes suffer brain injuries. during their careerfrom 1.6 to 3 million concussions associated with sports and recreation is held annually, about 300,000 of which are associated with football.

Cognitive changes after concussions are also common. A new study published in the Archives of Clinical Neuropsychology sheds light on the problem.

For Washington, concussions and their effects continued into college. During a football scholarship in Kansas: “I thought everything was fine. Even after the concussions, I was still able to get back into the game and my body retained the ‘muscle memory’ of how to play football and could follow directions even if my mind was no longer there.”

In the last year, due to a neck and spine injury, his sports career ended. “After that, everything went downhill,” he says. “I ended up in a terrible relationship, estranged from my family, and was even homeless for a while. I ended up in psychiatric hospitals, in dark places and with cognitive problems.”

Does concussion affect long-term cognitive functioning?

In the new study, researchers studied 353 former NFL players (average age 54) who had retired from playing for almost 3 decades.

Using a laptop or tablet, former players completed a series of neuropsychological tests through the TestMyBrain online platform. A number of cognitive functions were tested, including processing speed, visuospatial and working memory, short-term and long-term memory, and vocabulary.

The players completed a 76-item questionnaire that included 10 questions about the signs and symptoms of a concussion after being hit on the head while playing football: headaches, nausea, dizziness, loss of consciousness, memory problems, disorientation, confusion, seizures, problems with vision, or feeling unsteady on the legs. They were also asked if they had ever been diagnosed with a concussion.

Study senior author Laura Hermin, Ph.D., director of the Brain and Cognitive Technology Laboratory at McLean Hospital in Boston, says we know about the impact of concussions on short-term health, but “it’s not as clear how concussion history affects cognition in more recent years.” long term among former professional footballers”.

She says that “Former players had a lot of inconsistent results, so we wanted to address this issue using sensitive, up-to-date and objective measures of cognition in larger samples of former players than had previously been tested in such a study.”

One reason for the “mixed results” in earlier studies is that some of the studies focused on diagnosed concussions and cognitive problems. But many football players go undiagnosed with a concussion, so the researchers decided to pay special attention to concussion symptoms.

Accelerated cognitive aging

Former players who had more concussion symptoms performed worse on cognitive tests. For example, differences in visual memory between players with the highest and lowest concussion symptoms were equal to differences in cognitive ability between typical 35-year-olds and typical 60-year-olds.

On the other hand, lower cognitive ability was not associated with the number of concussions diagnosed, the number of years they played professional football, or the age they first played football.

The researchers conducted an additional study that compared 353 players with 5,086 men who did not play football. They found that cognitive performance was generally worse in former players.

“While our findings in this regard are not conclusive, we found the largest differences in cognitive ability (compared to men of the same age) among older gamers,” says Germine.

Long term cognitive problems

Washington continues to struggle with cognitive problems.

“My long-term memory sometimes seems intact, but after a while there are “holes” in it. Or I look at people and I can recognize the face, but I don’t remember who these people are.”

He also has reading and memory difficulties. “My eyes have tracking and tracking issues. And if I read aloud, I will stutter and spit and I will not be able to remember what I just read. Sometimes I put the remote in the freezer or put my phone outside and don’t know where it is.”

Washington graduated from college with a BA in Applied Behavioral Science, leading him to work with adults with developmental disabilities. However, schoolwork was difficult and has recently become even more difficult.

“I would like to become a social worker to help other people, but trying to take my courses may not be in my plans,” he says.

He is currently being treated for cancer and chemotherapy is also affecting his cognitive functions. “I got A’s for class work in one course, but I couldn’t remember anything on the final exam, so I got an A and failed the course,” he says.

He hopes that when the cancer passes, he will be able to try his hand at school again. Although the cognitive problems caused by his concussion remain formidable, “not having a ‘chemical brain’ will free up some cognitive abilities and hopefully I will study better and get a degree in social work.”

Get the right support

Germine says the results of the study “highlight the need for parents, the school system, and everyone who plays football to understand the importance of reporting any concussion symptoms, even if they don’t feel serious at the moment.”

She notes that “appropriate interventions to address and reduce the impact of head injuries—even in the absence of a diagnosed concussion—may be key to maintaining long-term cognitive health.”

In addition, “we must do our best to prevent head injuries and concussions in the first place. Heading-reducing measures are important to making football safer for brain development,” she says.

Washington and Snedaker are urging people to take head injuries seriously, not just “get back in the game” and get tested for concussions; and if a concussion is diagnosed, treating symptoms (such as emotional trauma, attention or memory problems, or vision problems).

In addition, both urge people who have received a concussion to get emotional support. Washington visits support groups offered American Brain Injury Association.