{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:45:08Z","timestamp":1777927508479,"version":"3.51.4"},"reference-count":66,"publisher":"SAGE Publications","issue":"15-16","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>\n                    Participation in collision and contact sport in Australia\u2014specifically rugby league\u2014is popular. With recent attention to the possible long-term health consequences of head impact exposure during a contact or collision sport career, the importance of understanding the contribution of modifiable risk factors as they relate to cognitive function has been highlighted. Risk factors for cognitive decline in the general population include cardiovascular health, sleep disorders, chronic pain, depression, anxiety, smoking, physical impairment, and physical inactivity. This study examined the associations between these risk factors and self-reported cognitive function in 130 former elite male rugby league players in Australia. Respondents were recruited through a survey distributed through former player groups and via word of mouth. Self-reported cognitive function was assessed using the Quality of Life in Neurological Disorders\u2014Applied Cognition General Concerns questionnaire. Risk factors for cognitive decline were self-reported, with questions collated from multiple validated sources, with each selected to explore specific categories of cognitive function. They included: questions from the Football Players Health Study at Harvard; The Australian Mental Health and Wellbeing Survey 2007; the Patient Reported Outcome Measurement Information System Item Banks for Pain Interference and Physical Function; and the Patient Health Questionnaire. Of the 130 participants, 43.1% (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 56) reported perceived cognitive impairment. When adjusted for age and number of concussion-related signs and symptoms experienced during their career, predictors of perceived cognitive difficulties included less than 5 h of sleep on average, history of stroke, current clinical symptoms of anxiety, physical impairment, and number of risk factors. The number of concussion-related signs and symptoms experienced was not related to perceived cognitive impairment, although it was associated with specific risk factors. Early education and intervention by medical professionals to manage these risk factors may provide a pathway for improving perceived cognitive health and functioning in former elite male rugby league players in the future.\n                  <\/jats:p>","DOI":"10.1089\/neu.2024.0543","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T03:57:22Z","timestamp":1746590242000},"page":"1453-1463","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Self-Reported Cognitive Difficulties and Their Modifiable Risk Factors in Former Elite Male Rugby League Players"],"prefix":"10.1177","volume":"42","author":[{"given":"Katherine","family":"Grellman","sequence":"first","affiliation":[{"name":"Sports Clinic, Christchurch, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver J.","family":"Smith","sequence":"additional","affiliation":[{"name":"Discipline of Exercise &amp; Sport Science, Sydney School of Health Sciences, Faculty of Medicine &amp; Health, The University of Sydney, Camperdown, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas P.","family":"Terry","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA."},{"name":"Center for Cognitive Neurosurgical Studies, Vanderbilt University School of Medicine, Nashville, Tennessee, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth L.","family":"Quarrie","sequence":"additional","affiliation":[{"name":"New Zealand Rugby, Wellington, New Zealand."},{"name":"Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand."},{"name":"Auckland Bioengineering Institute (ABI), The University of Auckland, Auckland, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7348-9570","authenticated-orcid":false,"given":"Grant L.","family":"Iverson","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA."},{"name":"Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, Massachusetts, USA."},{"name":"Mass General for Children Sports Concussion Program, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5031-5586","authenticated-orcid":false,"given":"Andrew J.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Discipline of Exercise &amp; Sport Science, Sydney School of Health Sciences, Faculty of Medicine &amp; Health, The University of Sydney, Camperdown, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"Australian Sports Commission. 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