{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:07:44Z","timestamp":1792066064362,"version":"4.4.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose:<\/jats:title>\n            <jats:p>Postmortem and experimental studies indicate a potential association between repeated concussions and stroke risk in older contact sport athletes. We examined the relationship between concussion and stroke history in former National Football League players aged \u226550 years.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Former professional football players aged \u226550 years who played \u22651 year in the National Football League were enrolled in the cross-sectional study. Indirect standardization was used to calculate overall and decade-specific standardized prevalence ratios. Logistic regression using Firth\u2019s bias reduction method examined the association between lifetime concussion history 0 (n=119; 12.2%), 1 to 2 (n=152; 15.5%), 3 to 5 (n=242; 24.7%), 6 to 9 (201; 20.5%), and 10+(n=265; 27.1%) and stroke. Adjusted odds ratios for stroke were calculated for concussion history groups, age, and coronary artery disease and\/or myocardial infarction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              The 979 participants who met inclusion criteria had a mean age of 65.0\u00b19.0 years (range, 50\u201399). The prevalence of stroke was 3.4% (n=33), significantly lower than expected based on rates of stroke in US men aged 50 and over (standardized prevalence ratio=0.56, Z=\u2009\u22124.56,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Greater odds of stroke history were associated with concussion history (10+ versus 0, adjusted odds ratio [95% CI]=5.51 [1.61\u201328.95]), cardiovascular disease (adjusted odds ratio [95% CI]=2.24 [1.01\u20134.77]), and age (1-year-increase adjusted odds ratio [95% CI]=1.07 [1.02\u20131.11]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The prevalence of stroke among former National Football League players aged \u226550 years was lower than the general population, with significantly increased risk among those with 10 or more prior concussions. Findings add to the evidence suggesting that traumatic brain injuries are associated with increased risk of stroke. Clinically, management of cardio- and cerebrovascular health may be pertinent to those with a history of multiple prior concussions.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.121.035607","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T10:00:15Z","timestamp":1638180015000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Cumulative Concussion and Odds of Stroke in Former National Football League Players"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2849-4658","authenticated-orcid":true,"given":"Benjamin L.","family":"Brett","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa (B.L.B., M.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1423-1259","authenticated-orcid":true,"given":"Zachary Y.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill (Z.Y.K., A.C., S.W., J.D.D., K.M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelum T.","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Rush Alzheimer\u2019s Disease Center, Chicago, IL (N.T.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2949-3668","authenticated-orcid":true,"given":"Avinash","family":"Chandran","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill (Z.Y.K., A.C., S.W., J.D.D., K.M.G.)."},{"name":"Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN (A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah","family":"Mannix","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital, MA (R.M., W.P.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2647-5701","authenticated-orcid":true,"given":"Samuel","family":"Walton","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill (Z.Y.K., A.C., S.W., J.D.D., K.M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3233-0699","authenticated-orcid":true,"given":"J.D.","family":"DeFreese","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill (Z.Y.K., A.C., S.W., J.D.D., K.M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6116-8462","authenticated-orcid":true,"given":"Ruben J.","family":"Echemendia","sequence":"additional","affiliation":[{"name":"Psychological and Neurobehavioral Associates, Inc, State College, PA (R.J.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8682-2130","authenticated-orcid":true,"given":"Kevin M.","family":"Guskiewicz","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina at Chapel Hill (Z.Y.K., A.C., S.W., J.D.D., K.M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"McCrea","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Wauwatosa (B.L.B., M.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"William P.","family":"Meehan","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital, MA (R.M., W.P.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097791"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.1948"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awx350"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318297eecf"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-324244"},{"key":"e_1_3_3_7_2","unstructured":"National Center for Health Statistics. National health interview survey sample adult questionaires. Accessed June 29 2021. https:\/\/www.cdc.gov\/nchs\/nhis\/2019nhis.htm."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030063"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadm.2017.10.003"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011827"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.121.035607","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T15:20:50Z","timestamp":1715613650000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.121.035607"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1161\/STROKEAHA.121.035607"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.121.035607","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"2021-04-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}