Younger start in tackle football linked to higher risk of behaviour, mood problems

Repeated blows to head during a critical time of development linked to difficulties later in life

Thomson Reuters Posted: Sep 25, 2017 3:23 PM EDT | Last Updated: September 25, 2017

Delaying the play of tackle football until a later age may be beneficial, but not necessarily risk free, medical researchers say. (Dominic Valente/The Ann Arbor News/Associated Press)

Boys who start playing tacklefootballbefore their12thbirthday may be at sharply increased risk ofbehavioural and mood problems later in life compared with peers whohit the gridiron later, according to a recent U.S. study.

Among former professional, college and high school footballplayers, those with earlier exposure to the game were more thantwice as likely to report impairments in regulating theirbehaviour, while they had triple the risk of depression symptoms,Dr. Robert Stern of Boston University and his colleagues found.

"The findings suggest that being hit in the head repeatedlyduring what might be a critical window of neurodevelopmentalvulnerability may increase risk for later-life emotional,behavioural and executive dysfunction," Stern told Reuters Healthin a telephone interview.

Repetitive head impacts, even when they do not lead to afull-fledged concussion, are associated with cognitive,
behavioural and mood problems in ex-football players, Stern'steam writes inTranslational Psychiatry. Repeated blows to thehead are also associated with chronic traumatic encephalopathy(CTE), a degenerative brain condition that can only be diagnosedafter death.

Not everyone exposed to repetitive head impacts developsCTE, the authors stress, so other factors including age atfirst exposure to play may make a person more or lessvulnerable to lasting brain damage.

The researchers had 214 former football players complete abattery of tests of behaviour, mood and cognition by telephone.Those who began playing before age 12 just under half of thegroup had more depressive symptoms and more apathy than thosewho started playing later.

Executive functioning, a set of mental skills that help people stay organized and get things done, was also worse, on average, in the players who started football earlier. These players also had more difficulty regulating their behaviour.

Repeated head impacts

Youth football players sustain about 250 head impacts perseason, and repeated head impacts have been associated withchanges in the white matter of the brain, Stern noted.

"The brain undergoes dramatic maturation and growththroughout childhood and adolescence, but there are severalbrain structures and the functioning of certain areas of thebrain that reach peak development during the years between ages10 and 12 in males,"he added.

That includes formation of aprotective myelin covering on brain cell axons, he noted, andpeak growth of critical structures in parts of the brain knownas the limbic system. Myelination allows nerves to transmitimpulses effectively, while the limbic system is important inemotional regulation.

"Right now there's a lot of discussion about whether youthfootball is indeed a safe thing for children to be doing," Sternsaid. "Maybe we should rethink how healthy and safe it is toexpose children to repeated blows to the head through youthfootball."

The findings don't mean it's safe to start playing footballafter age 12,he said. "At least putting off tackle footballuntil a later age may be beneficial, but not necessarilyoverall risk free. Anything we do to reduce the overall numberof repetitive hits to the head would in my mind be a stepforward."

The study is "important work," said Dr. Joel Stitzel of WakeForest School of Medicine in Winston-Salem, N.C., buthe noted that the study participants whose average age wasabout 51 were playing before the risks of head injury infootball were well-recognized.

Stitzel and his colleagues, who were not involved in thestudy, are currently conducting National Institutes ofHealth-funded research on head impact exposures in youthfootball players.

"There are a lot of changes to youth organizations andyouth leagues around the country that have taken place over thepast several years," he said, such as eliminating kickoffs andlimiting tackle football to older players. "Those are the thingsthat are going to make the game safer going forward."

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Younger start in tackle football linked to higher risk of behaviour, mood problems

Repeated blows to head during a critical time of development linked to difficulties later in life

Repeated head impacts

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