Long term neuropsychological outcome and effect of cognitive reserve in retired athletes

Objectives:
To examine the long-term neuropsychological outcome in retired, predominantly equestrian, athletes with a history of concussion and determine whether there is a protective role of cognitive reserve in the expression of cognitive impairment.

Design:
The neuropsychological functioning of retired athletes with a history of concussion was compared with controls.

Setting:
Private research clinic as part of the ICHIRF study.

Participants:
Male and female retired athletes and controls.

Interventions:
Participants were administered a battery of standardized neuropsychological tests.

Main Outcome Measure:
A principal components analysis regression was conducted, adjusted for participant characteristics. Premorbid function was used as an index of cognitive reserve.

Results:
Three components were identified that explained >95% of the variance in 14 neuropsychology tests; the first component (PC1) explained 87% of the variance. A regression model on PC1 identified an association between concussion and PC1, with lower scores in concussed participants with lower premorbid function.

Conclusions:
A history of concussion is associated with lower neuropsychological performance, and this is more pronounced in individuals with lower premorbid functioning, an indicator of cognitive reserve.