A study of former NFL players released Wednesday found that those who began playing football at younger ages showed more impaired long-term brain development than those who began later.
That could be a key finding for NFL players. But when it comes to young athletes and youth football, the biggest takeaway from the study appears to be that it is another reminder that more research is needed to assess the long-term impacts of playing football for youth athletes, the majority of whom never reach the NFL.
The study from the Boston University School of Medicine, published in the research journal Neurology and first reported by BuzzFeed, examined 42 former NFL players between the ages of 40 and 69 and found that those who began playing football before age 12 “demonstrated significantly greater impairment” than the players who did not start playing until after that age. The players who began before age 12, chosen as the age for the study because the years between ages 10 and 12 are considered an important stage of brain development, performed worse on three measures that were tested: verbal IQ, executive planning (reasoning), and memory recall.
The results suggest that suffering repeated head injuries “during critical periods of brain maturation could alter” the brain’s development and lead to “later-life cognitive impairments,” the study says.
The study, however, is limited in scope. Because it tested only former NFL players, its results cannot necessarily be applied to players who quit football before reaching the sport’s top level, and it is also uncertain whether the age of exposure to brain injuries is more important than the cumulative hits to the head players who eventually made it to the NFL suffered. The number of concussions participants suffered in their career, meanwhile, is estimated, and an accurate estimation is difficult for this age range, especially when attempting to account for those suffered at youth and high school levels.
Because of those limitations, the study says that it “does not allow for the determination of causality between early-life exposure” to repeated head trauma and “later-life impairments,” and its results cannot be applied generally to the football-playing public. Instead, it is relevant primarily to NFL players.
The limitations led another prominent concussion researcher to dismiss the study in comments to ESPN, while Dr. Robert Stern, who led the study for Boston U., told ESPN that despite the limitations the study “does suggest something that I think makes logical sense. The logic is you shouldn’t hurt your brain over and over and over again as a child.” Still, Stern, who did not immediately respond to interview requests, told the New York Times that the study isn’t definitive enough to be used to implement new rules changes at the youth level, and its abstract says merely that the study “may have implications for safety recommendations for youth sports.”
In that sense, while the study establishes a possible link between playing football at earlier ages and later cognitive problems in some NFL players, what it indicates for the broader football-playing public is how much more research is needed into how playing the sport — and suffering repeated head trauma — at young ages affects long-term cognitive abilities for those who stop long before they reach the game’s professional level.
The study itself says as much — it notes, “Future longitudinal studies beginning prior to the start of football participation in youth and using more comprehensive measures of intelligence are needed in order to determine the relationship between [repeated head injuries] in youth and intelligence.” — and in the interview with ESPN, Stern said that “more research needs to be done.” That has also been a key finding of other studies and compilations of studies into the impact of youth concussions, and President Obama has previously called for more research into the subject at a White House summit on youth concussions in sports.
That sort of research may be coming: the NFL, which reached a $765 million settlement with former players who alleged it covered up the effects of concussions, has agreed to fund research into the subject through partnerships with the National Institutes of Health (which funded this study), and other programs have been established to paint a clearer picture of how many concussions young athletes suffer and how that impacts their brains long-term.
This study may be a start, even if its limitations prevent it from being applied directly to younger athletes. But this is an important time for football. States and youth sports leagues are rushing to change rules and implement policies in an attempt to better recognize, treat, and manage concussions in young athletes. And with youth football participation rates dropping and concerns rising among parents about whether their children are safe playing the sport, the NFL is preaching safety directly to those parents to try to ease their fears. Amid all of that, it seems that for now the most important lesson of the Boston study is that we still need much more direct research to gain a clear picture of how hits to the head in football and other sports truly impact young athletes, and what we need to change to protect them and their futures.