Childhood Tackle Football Linked To Increased Risk of Depression and Cognitive Issues In Adulthood Interview with:

Michael Alosco, PhD NRSA Postdoctoral Fellow Boston University Alzheimer’s Disease & CTE Center Boston University School of Medicine 

Dr. Alosco

Michael Alosco, PhD
NRSA Postdoctoral Fellow
Boston University Alzheimer’s Disease & CTE Center
Boston University School of Medicine What is the background for this study? What are the main findings?

Response: TThe goal of this study was to investigate whether playing youth tackle football, particularly before the age of 12, is associated with worse emotional, behavioral, and cognitive difficulties later in life. Participants in this study included 214 former amateur and professional American football players who were part of the LEGEND study at Boston University. Participants had an average age of 51. 43 played high school football, 103 played college football, and there were 68 professional American football players. The former players were divided into two groups: those who began playing tackle football before age 12 and those who began at age 12 or older. Participants received telephone-administered cognitive tests and completed online measures of depression, behavioral regulation, apathy, and executive functioning, such as initiating activity, problem-solving, planning, and organization. Results from former players who started playing tackle football before the age of 12 were compared to those of participants who started playing at age 12 or later.

The study showed that participation in tackle football before age 12 increased the odds for having problems with behavioral regulation, apathy and executive functioning by two-fold and increased the odds for clinically elevated depression scores by three-fold. These findings were independent of the total number of years the participants played football or at what level they played, such as high school, college, or professional. Even when a specific age cutoff was not used, younger age of exposure to tackle football corresponded with worse clinical status. What should clinicians and patients take away from your report?

Response: These findings suggest that being hit in the head repeatedly through tackle football during critical times of brain development may increase vulnerability to later-life emotional and behavioral difficulties. Regardless of the results of this study, it makes sense that children, whose brains are rapidly developing, should not be hitting their heads over and over again.  This study supports that idea and suggests that there may be long-term consequences associated with experiencing these repeated hits during childhood. What recommendations do you have for future research as a result of this study?

Response: Much more research, particularly longitudinal studies, are needed to truly understand the association between youth football and long-term neurological consequences. The findings can also only be generalized to male former football players. More research is needed to study this question in athletes who played other sports and female athletes, as females generally reach milestones of brain development earlier than males. Is there anything else you would like to add?

Response: More research on this topic is needed before any recommendations on policy or rule changes can be made.  However, other research suggests that incurring repeated head impacts through collision and contact sports can lead to long-term neurological consequences, and we should be doing what we can at all levels in all sports to minimize these repeated hits, but especially in youth. Thank you for your contribution to the community.


M L Alosco, A B Kasimis, J M Stamm, A S Chua, C M Baugh, D H Daneshvar, C A Robbins, M Mariani, J Hayden, S Conneely, R Au, A Torres, M D McClean, A C McKee, R C Cantu, J Mez, C J Nowinski, B M Martin, C E Chaisson, Y Tripodis, R A Stern. Age of first exposure to American football and long-term neuropsychiatric and cognitive outcomes. Translational Psychiatry, 2017; 7 (9): e1236 DOI: 10.1038/tp.2017.197

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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Last Updated on September 19, 2017 by Marie Benz MD FAAD