Do Youth Contact Sports Lead to Cognitive and Mental Health Problems?

Football has taken a beating in recent years. Scandals, questions and deep-seated fears revolve around concussions and CTE, mental health and cognitive disorders that are believed to occur as a result of those concussions.

By extension other youth contact sports, including ice hockey, lacrosse, field hockey and even soccer have come under fire for the potential concussions young players can suffer while playing them. As a result of a cascade of research studies suggesting the relationship between concussions and resulting neural and mental disorders, as well as never-ending media coverage, one question has arisen, and seems to have already been answered in the affirmative.

Do youth contact sports lead to cognitive and mental health problems?

If a new University of Colorado Boulder research study is to be believed, we may have hastily arrived at the wrong answer to that question. Their study, which followed 11,000 youth athletes for 14 years, says that adolescents engaging in contact sports, including football, are at no greater risk of cognitive impairment, depression or suicidal thoughts in early adulthood than those who did not.

On top of that is the finding that those who play sports are less likely to suffer from mental health issues during their late 20’s to early 30’s. The study’s findings were published in the Orthopaedic Journal of Sports Medicine.

“There is a common perception that there’s a direct causal link between youth contact sports, head injuries and downstream adverse effects like impaired cognitive ability and mental health,” said lead author Adam Bohr, PhD, a postdoctoral researcher in the Department of Integrative Physiology. “We did not find that.”

This study follows on and seems to contradict a series of highly-publicized studies that made a connection between sports-related concussions among former pro football players and chronic traumatic encephalopathy (CTE,) mental health issues and cognitive decline as they aged. The fear engendered by the media coverage of the topic may be at least partially to blame for the decline of participation in youth tackle football nationwide.

Few of those studies, however, have focused solely on adolescent participation in contact sports. This one does.

“When people talk about NFL players, they are talking about an elite subset of the population,” said senior author Matthew McQueen, an associate professor of integrative physiology. “We wanted to look specifically at kids and determine if there are true harms that are showing up early in adulthood.”

Date from 10,951 participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health) was analyzed. Add Health includes a representative sample of children in 7th through 12th grades. They’ve been interviewed and tested repeatedly since 1994.

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Three groups were used. One group (in 1994) said they intended on playing contact sports. Another group planned to play non-contact sports and the last didn’t intend to play any sports. Among males, football accounted for 26% of intended sports participation.

The researchers determined via questionnaire whether participants had been diagnosed with depression or had thought about or attempted suicide through 2008. They also looked at scores on word and number recall tests. Scientists also controlled for education, race, socioeconomic status and other factors.

“We were unable to find any meaningful difference between individuals who participated in contact sports and those who participated in non-contact sports. Across the board, across all measures, they looked more or less the same later in life,” said Bohr.

While researchers have no clear reason for it, football players actually had a lower rate of early adult depression than other groups assessed. Those reporting having played no sports between the ages of 8 and 14 exhibited a 22% higher likelihood of depression during their late 20’s and 30’s.

“Right now, football is in many ways being compared to cigarette smoking — no benefit and all harm,” said McQueen, who is also director for the Pac-12 Concussion Coordinating Unit. “It is absolutely true that there is a subset of NFL players who have experienced horrible neurological decline, and we need to continue to research to improve our understanding of that important issue.”

But, he said, “the idea that playing football in high school will lead to similar outcomes later in life as those who played in the NFL is not consistent with the evidence. In fact, we and others have found there is some benefit to playing youth sports.”

A recent study from the University of Pennsylvania looked at 3,000 men in Wisconsin who had played football and graduated high school in 1957. They found that these men were no more at risk for cognitive impairment or depression later in life. One caveat regarding that study is the way the game of football has changed since the 1950’s.

The University of Colorado Boulder study is among the largest of its’ type so far and covers those who played in the 1990’s.

While the design of the dataset only allowed researchers to measure “intended” participation, the timing of the questionnaires makes it likely that those reporting participation followed through and played football.

Length of play, position played and whether players sustained a concussion or a sub-concussive head injury were also impossible to ascertain precisely. The researchers recognized that more studies looking at those factors will help create a more accurate picture of the situation.

“Few current public health issues are as contentious and controversial as the safety and consequences of participation in football,” they concluded. “Research on the risks of participation weighed with the risks of not participating in sports will enable parents and young athletes to make educated, informed decisions based on solid evidence.”

A new CU Boulder study, looking at the long-term mental and physical health of CU student-athlete alumni, is already underway.

So do youth contact sports lead to cognitive problems and mental health issues? This study seems to contradict the “conventional wisdom” regarding contact sports, concussions and cognitive problems, concussions, depression and other mental health problems.

However, given the large body of evidence claimed by other researchers to say the opposite, more research is needed. Until then, the definitive answer is “maybe.”

Keep the faith and keep after it!

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Journal Reference – Adam D. Bohr, Jason D. Boardman, Matthew B. McQueen. Association of Adolescent Sport Participation With Cognition and Depressive Symptoms in Early Adulthood. Orthopaedic Journal of Sports Medicine, 2019

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