Mixed Method Examination of the Brain Health of Former NCAA Division I Football Players and Former NFL Players

Objective The purpose of this study was to examine the concerns of brain health and wellness of former NCAA Division I (DI) football players compared to former NFL athletes. Background This study aimed to understand how post-concussion symptoms, measured using the Neurobehavioral Symptom Inventory (NSI), compare between former NCAA DI football players and former NFL players, and how groups of former athletes describe the role that playing football had on their brain health. Design/Methods We utilized a mixed methods design incorporating a survey of former NFL athletes and former NCAA DI football players (N = 150) and subsequent semi-structured interviews (N = 19). Survey data was analyzed using descriptive and inferential statistics; analysis of the interviews was descriptive. Results Several themes were captured from the interviews, including (1) concerns about living with the consequences of concussions, (2) concerns for developing long-term sequelae from concussions and chronic traumatic encephalopathy (CTE), (3) rationalizing concerns for long-term effects or symptoms, (4) difficulties differentiating between normal aging and long-term effects of concussions, and (5) concerns for the long-term sequelae from concussions in current and former athletes at all levels of football. There was a significant difference in the number of concussions sustained between former NCAA DI football players and former NFL athletes, but no significant difference in the NSI scores or self-reported worry about future brain health, measured on a scale from 1-8. Conclusions There was no significant difference in worry about brain health between former NFL and former NCAA DI football players despite former NCAA DI football players having significantly fewer self-reported concussions and less total playing time. This is significant for current and future healthcare professionals to recognize that worry about sequelae from concussions is individual to each patient. Players9 concerns about brain health in relation to multiple concussions will be important to address in future research.