%0 Journal Article
%T Cumulative concussion and odds of stroke in former National Football League players
%J Stroke
%D 2021
%A Brett, Benjamin L.
%A Kerr, Zachary Y.
%A Aggarwal, Neelum T.
%A Chandran, Avinash
%A Mannix, Rebekah
%A Walton, Samuel
%A DeFreese, J. D.
%A Echemendia, Ruben J.
%A Guskiewicz, Kevin M.
%A McCrea, Michael A.
%A Meehan, William P. 3rd
%V ePub
%N ePub
%P ePub-ePub
%X BACKGROUND AND PURPOSE: Postmortem and experimental studies indicate a potential association between repeated concussions and stroke risk in older contact sport athletes. We examined the relationship between concussion and stroke history in former National Football League players aged ≥50 years. <br><br>METHODS: Former professional football players aged ≥50 years who played ≥1 year in the National Football League were enrolled in the cross-sectional study. Indirect standardization was used to calculate overall and decade-specific standardized prevalence ratios. Logistic regression using Firth's bias reduction method examined the association between lifetime concussion history 0 (n=119; 12.2%), 1 to 2 (n=152; 15.5%), 3 to 5 (n=242; 24.7%), 6 to 9 (201; 20.5%), and 10+(n=265; 27.1%) and stroke. Adjusted odds ratios for stroke were calculated for concussion history groups, age, and coronary artery disease and/or myocardial infarction. <br><br>RESULTS: The 979 participants who met inclusion criteria had a mean age of 65.0±9.0 years (range, 50-99). The prevalence of stroke was 3.4% (n=33), significantly lower than expected based on rates of stroke in US men aged 50 and over (standardized prevalence ratio=0.56, Z= -4.56, P<0.001). Greater odds of stroke history were associated with concussion history (10+ versus 0, adjusted odds ratio [95% CI]=5.51 [1.61-28.95]), cardiovascular disease (adjusted odds ratio [95% CI]=2.24 [1.01-4.77]), and age (1-year-increase adjusted odds ratio [95% CI]=1.07 [1.02-1.11]). <br><br>CONCLUSIONS: The prevalence of stroke among former National Football League players aged ≥50 years was lower than the general population, with significantly increased risk among those with 10 or more prior concussions. <br><br>FINDINGS add to the evidence suggesting that traumatic brain injuries are associated with increased risk of stroke. Clinically, management of cardio- and cerebrovascular health may be pertinent to those with a history of multiple prior concussions.<p /> <p>Language: en</p>
%G en
%I Lippincott Williams and Wilkins
%@ 0039-2499
%U http://dx.doi.org/10.1161/STROKEAHA.121.035607