Concussion history in NCAA athletes yields mixed health outcomes

New research investigating health outcomes in NCAA athletes during their first year after leaving college sports found that some health measures were worse than expected, but others actually improved.

The results varied depending on the athletes’ history of contact exposure and the number of years they played their sport.

“In athletes that are ending their collegiate careers, those with more concussions reported worse outcomes on certain health measures,” said Reid Syrydiuk, first author on the study and a doctoral candidate in kinesiology studying at the University of Michigan Concussion Center.

“Interestingly, those participating in a higher contact sport reported better mental and symptom health scores than those in noncontact sports. Further, those with increased number of years playing their primary sport reported better mental health scores.”

The findings counter the narrative associating concussion with mental health deficits, and suggest that the benefits derived from the team environments seen with contact sports may be somewhat protective, he said.

The study, which appears in the journal Brain Injury, is also novel in that it explores a period that hasn’t been studied much: the time when students are transitioning out of college sport. The research is funded by the NCAA and the U.S. Department of Defense.

Bridging the research gap

Most studies on concussions and health fall into one of two categories: acute (hours or days post-injury) or long term (decades into retirement.) This focus leaves a significant gap in understanding the health of athletes as they undergo the massive life change of exiting competitive sport.

To that end, researchers analyzed health questionnaires completed within one year of leaving college by 3,663 student-athletes in the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium, to assess how concussion history, sport contact exposure and years of participation were associated with their health at the end of their collegiate career, an intermediate time period that has not been studied much.

Athletes completed eight self-reported health questionnaires spanning factors including cognition, mental health, physical health and neurobehavioral health. Key findings:

• Concussion history: Athletes with three or more concussions across a variety of sports reported increased depressive symptoms and worsened neurobehavioral (e.g., irritability, concentration) symptoms compared to those with no concussions.
• Benefits of participation: Athletes reporting more years of participation in their primary sport consistently reported better mental health scores.
• Sport type comparison: Athletes in contact sports reported better mental health (specifically lower depression scores) and neurobehavioral symptom scores compared to noncontact athletes.

“If I consider why these contact sport athletes report better scores on certain outcomes, I think it could be related to the large-team environments they experience,” Syrydiuk said.

The CARE Consortium is a national concussion research network of NCAA athletes and U.S. military service academy cadets across 30 different institutions. Steven Broglio, director of the Michigan Concussion Center and U-M professor of kinesiology, is a principal investigator on the CARE study.

Fostering early intervention

An important practical application is identifying groups that could benefit from early intervention and support as they leave their college athletics, Syrydiuk said.

“This time period is important because it hasn’t typically been used before in this type of sport medicine research,” he said. “It both bridges a gap in literature, which is typically studying concussions in the acute and the long term, and it fosters early support for those leaving sport.”

Practical applications could include increased monitoring, such as follow-up mental health screenings for identified at-risk groups postgraduation or targeted resources, such as offering access to counseling or tailored transition support programs for those with significant concussion history.

The change of leaving sport is a critical moment.

“For the majority of these collegiate athletes, their competitive careers end with graduation,” Syrydiuk said. “That’s a very big change in their lives. We don’t want to just ignore them after they’ve left sport.

“If we can identify groups that are more at risk as they’re leaving sport versus decades after they’ve retired, we can intervene earlier and hopefully increase the likelihood of improving their self-reported health. By identifying who needs support as they transition out of sport, we have a better chance of preventing their health from worsening over time.”

Other co-authors are: Adrian Boltz of U-M; Jaroslaw Harezlak, Chengyun Li, Thomas McAllister, Kelly Mosesso, Susan Perkins and Jie Ren of Indiana University; Allyssa Memmini of the University of New Mexico; Paul Pasquina of the Uniformed Services University of the Health Sciences; Landon Lempke of Virginia Commonwealth University; and Michael McCrea of the Medical College of Wisconsin.