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. 2021 Mar;92(3):282-290.
doi: 10.1136/jnnp-2020-324244. Epub 2021 Jan 22.

Distinct latent profiles based on neurobehavioural, physical and psychosocial functioning of former National Football League (NFL) players: an NFL-LONG Study

Benjamin L Brett  1   2 , Samuel R Walton  3 , Zachery Y Kerr  3 , Lindsay D Nelson  4   2 , Avinash Chandran  5 , J D Defreese  3 , Ruben J Echemendia  6 , Kevin M Guskiewicz  3 , William P Meehan Iii  7 , Michael A McCrea  4   2
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Distinct latent profiles based on neurobehavioural, physical and psychosocial functioning of former National Football League (NFL) players: an NFL-LONG Study

Benjamin L Brett et al. J Neurol Neurosurg Psychiatry. 2021 Mar.

Abstract

Objective: To identify subgroups of former National Football League (NFL) players using latent profile analysis (LPA) and examine their associations with total years of participation (TYP) and self-reported lifetime sport-related concussion history (SR-CHx).

Methods: Former NFL players (N=686) aged 50-70 years, with an average 18.0 TYP (±4.5) completed a questionnaire. SR-CHx distributions included: low (0-3; n=221); intermediate (4-8; n=209) and high (9+; n=256). LPA measures included: Quality of Life in Neurological Disorders Emotional-Behavioral Dyscontrol, Patient Reported Outcomes Measurement Information System Cognitive Function, Emotional Support, Self-Efficacy, Meaning and Purpose, Physical Function, Pain Interference, Participation in Social Roles and Activities, Anxiety, Depression, Fatigue, and Sleep Disturbance. Demographic, medical/psychiatric history, current psychosocial stressors, TYP and SR-CHx were compared across latent profiles (LPs).

Results: A five profile solution emerged: (LP1) global higher functioning (GHF; 26.5%); (LP2) average functioning (10.2%); (LP3) mild somatic (pain and physical functioning) concerns (22.0%); (LP4) somatic and cognitive difficulties with mild anxiety (SCA; 27.5%); LP5) global impaired functioning (GIF; 13.8%). The GIF and SCA groups reported the largest number ofe- medical/psychiatric conditions and higher psychosocial stressor levels. SR-CHx was associated with profile group (χ2(8)=100.38, p<0.001); with a higher proportion of GIF (72.6%) and SCA (43.1%) groups reporting being in the high SR-CHx category, compared with GHF (23.1%), average (31.4%) and somatic (27.8%) groups. TYP was not significantly associated with group (p=0.06), with greater TYP reported by the GHF group.

Conclusions: Five distinct profiles of self-reported functioning were identified among former NFL players. Several comorbid factors (ie, medical/psychiatric diagnoses and psychosocial stressors) and SR-CHx were associated with greater neurobehavioural and psychosocial dysfunction.

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Conflict of interest statement

Competing interests: RE is a paid consultant for the NHL and co-chair of the NHL/NHLPA Concussion Subcommittee. He is also a paid consultant for Major League Soccer and Princeton University Athletic Medicine and occasionally provides expert testimony in matters related to MTBI and sports concussion.AC reports funding from the National Collegiate Athletic Association (NCAA) as the Director of the NCAA Injury Surveillance Program WM receives royalties from (1) ABC-Clio publishing for the sale of his books, Kids, Sports, and Concussion: A Guide for Coaches and Parents, and Concussions; (2) Springer International for the book Head and Neck Injuries in Young Athlete and (3) Wolters Kluwer for working as an author for UpToDate. His research is funded, in part, by philanthropic support from the National Hockey League Alumni Association through the Corey C. Griffin Pro-Am Tournament and a grant from the National Football League. MM acknowledges researching funding from the NIH, Department of Defense, CDC, NCAA and NFL to the Medical College of Wisconsin.

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