A - 14 Stability of Cognitive and Neurobehavioral Symptom Endorsement in Older Former NFL Players and Influential Factors

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Abstract Purpose To investigate the stability of cognitive and neurobehavioral symptoms over time in former professional football players; characterize impairment and change rates; examine factors associated with symptom endorsement changes. Method Former players (N = 219; M = 57.7(SD = 6.1) years of age) completed a health questionnaire including self-rated measures of cognition (PROMIS Cognitive-SF) and executive function (Neuro-QoL Emotional and Behavioral Dyscontrol-SF) at two timepoints (time between M = 23.7(SD = 14.4) months). Descriptive statistics characterized impairment and change rate proportions. Correlations (controlling for time between visits) and ANOVA examined associations of a priori factors and symptom endorsement change (T-score difference). Results Symptom endorsement was stable for cognition (r = 0.66, p < 0.001) and executive function (r = 0.66, p < 0.001). Similar proportions of individuals were >/=1SD beyond the mean toward impairment at Time-1 (cognition = 25.1%; executive dysfunction = 16.4%) and Time-2 (cognition = 27.0%; executive dysfunction = 16.7%). The greatest proportion of individuals were within normal limits at Time-1 and remained so at Time-2 (cognition = 65.3%; executive dysfunction = 74.6%), though improvement and decline were also observed (cognition improvement = 7.7%, decline = 9.6%; executive dysfunction improvement = 8.7%, decline = 8.9%). Higher depression and pain interference symptoms and lower education and self-efficacy at Time-1 were significantly associated with improvement in cognitive and executive function symptoms (r = |0.15–0.36|, p = 0.025- <0.001). Greater concussion history was associated with improved cognition ratings, P = 0.22, p = 0.001. Conclusions Cognitive and neurobehavioral symptoms remain generally stable over time in older former football players, though a notable proportion experience change in both directions. Worse clinical functioning in multiple domains at Time-1 was associated with greater improvement in symptoms over time, suggesting opportunities for potential improvement in cognitive symptoms in those experiencing difficulties.

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