Citation

Gallo V, McElvenny D. Aging (Albany NY) 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Impact Journals, LLC)

DOI

10.18632/aging.204431

PMID

36495590

Abstract

In contrast with the neuropathological evidence accumulating on Chronic Traumatic Encephalopathy (CTE) [1] and its relation to concussion and the severe clinical consequences, the evidence coming from the sport research is not always consistent. For example, a recent study conducted among former elite English rugby players, the BRAIN study, found no overall evidence of an association between number of concussions suffered when playing and cognitive function at an older age [2]. The study, featuring an in depth evaluation of cognitive function, found an increased risk of poorer cognition in those who suffered three or more concussions compared to none, but only after age 70-75 years. This suggests the presence of an association which is delayed compared to that found in previous studies conducted among French, Scottish, and New Zealand rugby players [3]. If the effect in English rugby players is a true effect, why might such a delayed effect on cognition occur when compared to other rugby players, or players of other contact sports?

It is possible that the reason needs to be researched in the characteristics of this same group of sportspersons, that is, with very high socio-economic status. In England, rugby union is a sport played by players from a higher than average socioeconomic status. Among the English rugby players involved in the BRAIN study, three out of four have at least an undergraduate university degree, with one in three holding a postgraduate degree. Three quarters of the former players were working as legislators, senior officials, managers or professionals. Conversely, 52% of the French rugby players and between 18% and 26% of the New Zealand had a high school degree or above; Scottish players had a mean number of years spent in education of 16 (SD 6.2) [3].

Epidemiological studies have suggested that some individual cognitive circumstances such as education attainment, occupational demand, and type of leisure activities can increase cognitive reserve. This in turn can provide an increased resilience of the brain to neuropathological changes delaying the detrimental effect of external exposures, which might explain the difference in age onset of the symptoms between the BRAIN study and the other rugby studies...

Language: en

Keywords

concussion; cognitive decline; sport; rugby; structural inequalities