Lifetime Stress, Concussion History, and Quality of Life in Retired Team USA Athletes

Purpose To investigate whether lifetime stressor exposure (personal, sport-related, or retirement-specific) and concussion history are associated with health-related quality of life (HRQoL) in retired Team USA elite athletes, and whether concussion contributes uniquely beyond lifetime stress exposure. Method A convenience sample of 53 retired Team USA athletes (M age= 42.04 years [SD = 6.60]; 51% female) completed an online survey, with 24.5% endorsing a concussion history. Mental and physical HRQoL (VR-12), personal stressors (Adult STRAIN total count), sport-related stressors (Sport SAM), and retirement-specific stressors (Elite Athlete Retirement Stressor Index) were assessed. Results Concussion history was associated with greater personal stress exposure (t(51)=3.29, p=.002). In predicting mental HRQoL, stress variables explained 31% variance beyond age (p < .001), among which retirement-specific stress emerged as the strongest independent predictor (β=−.55, p<.001). Concussion did not contribute unique variance (ΔR2 < .001, p=.99). For physical HRQoL, stress variables accounted for 16% of variance (p=.035), with sport-related stress independently predicting poorer outcomes (β =−.37, p=.017). Concussion again was not significant (ΔR2=.001, p =.815). Conclusions Concussion history did not independently predict mental or physical HRQoL beyond lifetime stress burden. Instead, retirement-specific stress most strongly predicted mental HRQoL, whereas sport-related stress most strongly predicted physical HRQoL. These findings suggest that long-term well-being in retired elite athletes may be more related to cumulative psychosocial stress exposure than concussion history alone, underscoring the importance of comprehensive stress assessment and integrated models of athlete healthcare.