Concussion and long-term cognitive function among rugby players-The BRAIN Study

Valentina Gallo; Damien M McElvenny; Giulia Seghezzo; Simon Kemp; Elizabeth Williamson; Kirsty Lu; Saba Mian; Laura James; Catherine Hobbs; Donna Davoren; Nigel Arden; Madeline Davies; Andrea Malaspina; Michael Loosemore; Keith Stokes; Matthew Cross; Sebastian Crutch; Henrik Zetterberg; Neil Pearce

doi:10.1002/alz.12455

Concussion and long-term cognitive function among rugby players-The BRAIN Study

Alzheimers Dement. 2022 Jun;18(6):1164-1176. doi: 10.1002/alz.12455. Epub 2021 Oct 20.

Authors

Valentina Gallo^{1

2

3

4}, Damien M McElvenny^{2

5

6}, Giulia Seghezzo¹, Simon Kemp^{2

7}, Elizabeth Williamson², Kirsty Lu⁸, Saba Mian², Laura James¹, Catherine Hobbs^{2

9}, Donna Davoren², Nigel Arden¹⁰, Madeline Davies^{9

10}, Andrea Malaspina¹¹, Michael Loosemore¹², Keith Stokes^{7

9}, Matthew Cross^{9

13}, Sebastian Crutch⁸, Henrik Zetterberg^{14

15

16

17}, Neil Pearce²

Affiliations

¹ Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK.
² Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
³ School of Public Health, Imperial College London, London, UK.
⁴ Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands.
⁵ Research Group, Institute of Occupational Medicine, Edinburgh, UK.
⁶ Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK.
⁷ Rugby Football Union, London, UK.
⁸ Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK.
⁹ Department of Health for Keith Stokes and Madeleine Davies, Department of Psychology for Catherine Hobbs, University of Bath, Bath, UK.
¹⁰ Centre for Sport, Exercise & Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK.
¹¹ Blizard Institute, Queen Mary University of London, London, UK.
¹² Institute of Sport Exercise and Health, University College London, London, UK.
¹³ Premiership Rugby, London, UK.
¹⁴ UK Dementia Research Institute, UCL Queen Square Institute of Neurology, London, UK.
¹⁵ UK Dementia Research Institute, University College London, London, UK.
¹⁶ Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
¹⁷ Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.

Abstract

Objective: The BRAIN Study was established to assess the associations between self-reported concussions and cognitive function among retired rugby players.

Methods: Former elite-level male rugby union players (50+ years) in England were recruited. Exposure to rugby-related concussion was collected using the BRAIN-Q tool. The primary outcome measure was the Preclinical Alzheimer Cognitive Composite (PACC). Linear regressions were conducted for the association between concussion and PACC score, adjusting for confounders.

Results: A total of 146 participants were recruited. The mean (standard deviation) length of playing career was 15.8 (5.4) years. A total of 79.5% reported rugby-related concussion(s). No association was found between concussion and PACC (β -0.03 [95% confidence interval (CI): -1.31, 0.26]). However, participants aged 80+ years reporting 3+ concussions had worse cognitive function than those without concussion (β -1.04 [95% CI: -1.62, -0.47]).

Conclusions: Overall there was no association between concussion and cognitive function; however, a significant interaction with age revealed an association in older participants.

Keywords: cognitive function; occupational epidemiology; rugby; sports-related concussion.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Athletic Injuries* / epidemiology
Athletic Injuries* / psychology
Brain Concussion* / epidemiology
Cognition
Football*
Humans
Male
Rugby