Concussions and Alzheimer's: The High Cost of Playing in the NFL

By Sheilah Downey

Most major league football players face a weekly pummeling on the field,  sending many of them limping to the sidelines with injuries to their bodies, and all-too-often, their brains.

The concussion controversy in the National Football League (NFL) has been a source of contention between players and coaches for decades with some -- even players -- shrugging it off with the adage "it's all part of the game."

As a new NFL-commissioned study confirms, the stakes may be getting higher.

Autopsies on the brains of six former NFL players in recent years concluded that all of them suffered from chronic traumatic encephalopathy (CTE), brian damage caused by repeated concussions. CTE has been linked to early-onset of Alzheimer's disease, depression and other mental problems.

Boston University's Chris Nowinski, co-director of the Center for the Study of Encephalopathy (CTSE), says it's likely that many pro players will eventually develop the disease at a fairly young age.

"Everybody in the pros is at some risk," he said in a San Francisco Chronicle article this month, "and some of them, a very significant percentage, are going to develop CTE with an average onset of the disease sometime in his 40s."

CSTE studies have revealed brown tangles that permeate the brain tissue of former NFL players who died young, some in their 30s or 40s. Doctors with the Center said the damage was located deep in the brain, not just on superficial areas. They also found that the tangles closely resemble what might be found in the brain of an 80-year-old with dementia.

Quarterbacks Troy Aikman and Steve Young both suffered career-ending concussions. When Tim Tebow, All-American quarterback for the Florida Gators, suffered a concussion in a game last week, a Washington Post editorial suggested he call Aikman before returning to play.

Andre Waters, former Eagle's defensive back, suffered from severe depression and committed suicide in 2006 at age 44. An autopsy revealed the depression stemmed from repeated blows to the head.

The NFL estimates that there's one concussion at every other game, or between 100-150 players each season. Realizing the growing concern of the problem, the League held a conference to address the issue in 2007, instituting brain baseline testing for all NFL players and a "whistle-blower" hotline for those who are forced to play while still injured.

But, according to the NFL study released this week, by the University of Michigan's Institute for Social Research, concussions are only one of a long list of physical and mental problems that will torment most players long after they have hung up their helmets.

Not only do NFL retirees suffer greater rates of Alzheimer's than the general population, most of them have off-the-chart levels of arthritis, have pain lasting most of the day, and higher cancer rates than most people in the country, the study found.

"NFL retirees are much more likely to report all types of pain than the general population," says the study. An astounding 80 percent of NFL retirees ages 30 to 49 reported pain lasting most of the day.

The random study was done in telephone interview in 2008 and looked at 1,063 retired NFL players divided into two groups, those aged 30 to 49 and another group of 50 years and over.

And after taking years of head butts and body blows on the playing field,  the majority of NFL retirees had experiences with depression and Alzheimer's disease.

"Taken together," said the study, "one in four NFL retirees has either been diagnosed with depression or experienced an episode of major depression in their lifetime."

The study also found that 6 percent of the 50 year or older NFL retirees had experienced dementia, Alzheimer's or memory-related disease, compared to a 1.2 percent of men in the same age group.

"At 6 percent, the older group of retirees is particularly high," the study states. "Further research on this is warranted."

Although they didn't take specifics, even cancer rates are a concern for the ex-NFL players.

"Cancer reports are higher among NFL retirees," says the study, "however, there was no probe of what type of cancer."

Not surprisingly, the grueling work outs have led to "striking" levels of  arthritis for most players. NFL retirees have a five times higher rate of arthritis than men in the general population. More than 41 percent of NFL retirees ages 30 to 49 reported arthritis, compared to 8.7 percent of men in the general population. More than 62 percent of the retirees over age 50 reported arthritis.

Having a joint replaced is almost commonplace in retirees. The study found that nearly one out of four older NFL retirees have had at least one joint surgically replaced. Twenty three percent of older retirees said they had some joint replacement, 12.7 reported they had a left knee replaced, 11.3 percent a right knee. Hip replacements were less common, with 4.6 percent saying they had a right hip replaced, and 5 percent a left hip.

While the study said that younger NFL retirees weren't as likely to have a joint replacement at the time of the survey, researchers said the outlook is none too bright.

"Rates are lower in the younger group but it is reasonable to expect they will increase rapidly as that group ages," it stated, "given the levels of pain involved."

More than 44 percent of the younger retirees, ages 30 to 49, reported difficulty just standing for two hours at a time. In that same age group, 47.2 percent said they had trouble stooping, bending or kneeling.

The Good News

With their usually above average physical shape, NFL retirees will be ducking some of the commonplace ailments most face.

NFL retirees reported fewer heart attacks than those in the general population, and were also less likely to suffer strokes or angina.

The study attributed this to the fact that the majority of the players either never smoked cigarettes or do not smoke now.

Former players were also less likely to have diabetes or asthma, the study said.

For more information on concussion, visit http://en.wikipedia.org/wiki/Concussion