Former professional contact and collision sport (CCS) athletes, particularly American football players, are at risk for later-life neurological disorders and chronic conditions. Little is known about health outcomes of amateur athletes. We examined self-reported health conditions among former Kent State University (KSU) CCS athletes and non-contact and collision sport (non-CCS) athletes.

A 60-question survey of neurological, cardiovascular, psychiatric diagnoses and substance use was sent to 8115 former KSU athletes between October 2021 to January 2022. Athletes were grouped into CCS (American football, ice hockey, rugby, soccer, wrestling, lacrosse) and non-CCS. Binary logistic regression analyses tested the association between playing CCS at KSU and self-reported survey outcomes, controlling for age and sex. As a sensitivity analysis, we ran binary logistic regression models to test the association between years of football play and all health outcomes.

502 (6.2%) participants completed the survey of which 463 were usable responses: 160 athletes played CCS (mean age: 59.2, SD = 16.0, 62.5% reported American football as their primary sport) and 303 athletes played non-CCS (mean age: 54.0, SD=16.9, 20.1% reported track and field as their primary sport). CCS were older (P <0.01) and predominately male (P <0.0001). All analyses were adjusted for age and sex.

CCS athletes had increased odds of reported cognitive complaints including memory (OR = 2.43, 95% CI [1.47, 4.08], P_adj < 0.01), attention/concentration (OR = 2.19, 95% CI [1.31, 3.37], P_adj = 0.01), problem solving/multi-tasking (OR = 2.46, 95% CI [1.11, 5.68], P_adj = 0.05), and language (OR = 2.32, 95% CI [1.24, 4.48], P_adj = 0.02). Participation in CCS was also associated with increased odds of reported neuropsychiatric symptoms including anxiety (OR = 1.88, 95% CI [1.09, 3.29], P_adj = 0.04), impulsivity (OR = 2.81, 95% CI [1.28, 6.43], P_adj = 0.02), short-fuse/rage/explosivity (OR = 4.78, 95% CI [2.49, 9.61], P_adj <0.001), and violence/aggression (OR = 4.80, 95% CI [1.72, 16.31], P_adj = 0.02). In addition, CCS athletes were at increased odds for reported sleep apnea diagnoses compared with the non-CCS athletes (OR = 2.18, CI [1.24, 3.90], P_adj = 0.02). There were no group differences in cardiovascular and physical health outcomes.

Post-hoc analyses revealed years of football play was significantly associated cognitive complaints of memory (OR = 1.11, 95% CI [1.05, 1.17], P_adj < 0.001), attention/concentration (OR = 1.08, 95% CI [1.02, 1.14], P_adj = 0.01), problem solving (OR = 1.12, 95% CI [1.03, 1.21], P_adj = 0.01), language (OR = 1.09, 95% CI [1.02, 1.17], P_adj = 0.01). Years of football play was also associated with increased odds of impulsivity (OR = 1.09, 95% CI [1.01, 1.18], P_adj = 0.03), short fuse(OR = 1.16, 95% CI [1.09, 1.23], P_adj < 0.0001), violence/aggression (OR = 1.14, 95% CI [1.05, 1.26], P_adj < 0.01) but not anxiety (OR = 0.05, 95% CI [1.05, 1.26], P_adj = 0.60).

Former KSU CCS athletes reported greater cognitive, mood, and behavior complaints and had higher rates of sleep apnea. Millions play college contact sports each year, thus research on chronic health outcomes is a high priority.