{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:08:28Z","timestamp":1756253308637,"version":"3.44.0"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"University of North Carolina Injury Prevention Research Center"},{"DOI":"10.13039\/100005217","name":"National Center for Injury Prevention and Control","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005636","name":"National Operating Committee on Standards for Athletic Equipment","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005636","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012676","name":"National Collegiate Athletics Association","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012676","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,25]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess changes in neurocognitive test scores among former collegiate American football players over 18\u00a0years and examine associations with head trauma history.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Former collegiate American football players (n\u2009=\u200931; aged\u2009=\u200938.4\u2009\u00b1\u20091.3\u00a0years) self-reported their concussion history and repetitive head impact exposure (Head Impact Exposure Estimate). Neurocognitive testing was conducted at two time-points (during college [T1] and 18-year follow-up [T2]) via Hopkins Verbal Learning Test\u2013Revised Immediate and Delayed Recall; Verbal fluency; Symbol Digit Modalities Test; and Trail-Making Test-B. Raw score changes were calculated, with accompanying Cohen\u2019s d effect sizes and coefficients of variation. Repeated-measures analyses of covariance models were fit to examine changes in test performance. Multivariable linear regression models tested associations of sport-related concussion history and repetitive head impact exposure with change scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>No significant changes in cognitive test performance were observed (ps\u2009\u2265\u2009.06). Individual-level changes exhibited high variability (coefficients of variation \u2265 244%), and group-level effects were small to medium (d\u2009\u2264\u20090.41). Neither sport-related concussion history nor repetitive head impacts were related to change scores (ps\u2009&amp;gt;\u2009.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Group-level test scores did not change over 18\u00a0years among former collegiate football players now in midlife, though individual-level variability was high. Sport-related concussion and head impact exposure estimates were not related to change. Longitudinal studies are essential to understand cognitive trajectories of former football players and factors influencing those trajectories.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/arclin\/acaf032","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T16:55:52Z","timestamp":1746464152000},"page":"1221-1230","source":"Crossref","is-referenced-by-count":0,"title":["An 18-Year Study of Changes in Neurocognitive Function and Associations with Repetitive Head Trauma among Former Collegiate American Football Players: A Case Series"],"prefix":"10.1093","volume":"40","author":[{"given":"Samuel R","family":"Walton","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine , Richmond, VA 23298 ,","place":["USA"]},{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill , Chapel Hill, NC 27514 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary Yukio","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill , Chapel Hill, NC 27514 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob R","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill , Chapel Hill, NC 27514 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly S","family":"Giovanello","sequence":"additional","affiliation":[{"name":"Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill , Chapel Hill, NC 27599 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A","family":"McCrea","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin , Milwaukee, WI 53226 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin M","family":"Guskiewicz","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill , Chapel Hill, NC 27514 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin L","family":"Brett","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin , Milwaukee, WI 53226 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"issue":"1","key":"2025082604220870100_ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13195-022-01147-9","article-title":"Neuropsychological test performance of former American football players","volume":"15","author":"Alosco","year":"2023","journal-title":"Alzheimer's Research & Therapy"},{"key":"2025082604220870100_ref2","doi-asserted-by":"publisher","first-page":"440","DOI":"10.3389\/fnhum.2019.00440","article-title":"Interactive effects of racial identity and repetitive head impacts on cognitive function, structural MRI-derived volumetric measures, and cerebrospinal fluid tau and A\u03b2","volume":"13","author":"Alosco","year":"2019","journal-title":"Frontiers in Human Neuroscience"},{"key":"2025082604220870100_ref3","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/acac107","article-title":"Comparison of various metrics of repetitive head impact exposure and their associations with neurocognition in collegiate-aged athletes","volume":"38","author":"Amadon","year":"2023","journal-title":"Archives of Clinical Neuropsychology"},{"issue":"4","key":"2025082604220870100_ref4","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1177\/23259671211001129","article-title":"Factors influencing college football players\u2019 beliefs about incurring football-related dementia","volume":"9","author":"Baugh","year":"2021","journal-title":"Orthopaedic Journal of Sports Medicine"},{"volume-title":"Hopkins verbal learning test \u2013 Revised. 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