Mood disorders drive feelings of cognitive decline in former college athletes
UT Southwestern study finds emotional health outweighs concussion history in shaping perceptions of impairment
DALLAS – Jan. 23, 2025 – Former college athletes with a history of concussions were more likely to perceive themselves as cognitively impaired later in life if they had mood disorders such as depression and anxiety – even when testing showed no such decline in mental acuity, a study by UT Southwestern Medical Center researchers has found.
The findings, published in The Clinical Neuropsychologist, challenge existing perceptions about brain health in aging athletes and highlight the potential for addressing mental health to improve quality of life and reduce cognitive concerns.
“Our findings suggest that concussion history may not play much of a role in brain health outcomes later in life for the majority of former athletes,” said senior author C. Munro Cullum, Ph.D., Professor of Psychiatry, Neurological Surgery, and Neurology and Vice Chair and Chief of the Division of Psychology at UT Southwestern. “In some cases, treating a former athlete’s depression may be more helpful than focusing on their history of concussions.”
The study analyzed data from 407 former college athletes ages 50 and older who participated in UT Southwestern’s College Level Aging Athlete Study (CLEAATS). Participants reported concussion histories, underwent cognitive tests, and shared details about mood symptoms and memory concerns.
While athletes with five or more concussions reported higher levels of depressive symptoms and greater subjective cognitive complaints, objective cognitive testing revealed no significant differences in cognitive functioning across concussion history groups. Statistical analysis confirmed that mood disorders, including depression and anxiety, were the strongest predictors of subjective cognitive complaints, independent of concussion history.
The study builds on prior UT Southwestern research exploring the relationships between head injuries, mood, and cognition. Earlier findings identified depression as a key factor in predicting subjective cognitive concerns and underscored its role in conditions like traumatic encephalopathy syndrome.
“This study increases our knowledge on long-term risk for depression, dementia, and mild cognitive impairment after concussion among former male and female athletes,” said study co-author Jeffrey Schaffert, Ph.D., Assistant Professor of Psychiatry at UT Southwestern.
The findings also highlight the resilience of many former college athletes. Despite subjective complaints, objective cognitive impairments were rare, suggesting good cognitive health in most participants. Athletes experiencing depressive symptoms were more likely to perceive memory or attention difficulties, pointing to a psychological rather than neurological basis for their concerns.
“This research advances the field by highlighting the critical role of mood symptoms in subjective cognitive concerns in aging, suggesting a need to prioritize mental health assessment and intervention in managing long-term concussion effects in former athletes,” said Dr. Schaffert.
Future research will explore additional factors influencing brain health including medical history, social determinants, and resilience. These efforts aim to provide a comprehensive understanding of the aging athlete population and offer improved approaches for brain and mental health challenges.
Other UTSW researchers who contributed to this study include lead author Alison Datoc, Ph.D., and Gavin D. Sanders, Ph.D., both postdoctoral fellows at the time of the work; Tahnae Tarkenton Allen, Ph.D., Adjunct Assistant Professor of Psychiatry; and Nyaz Didehbani, Ph.D., Adjunct Associate Professor of Psychiatry and Physical Medicine & Rehabilitation.
Dr. Cullum is also an Investigator with the Peter O’Donnell Jr. Brain Institute and holds the Pam Blumenthal Distinguished Professorship in Clinical Psychology.
This research was funded in part by the Darrell K Royal Research Fund.
About UT Southwestern Medical Center
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 25 members of the National Academy of Sciences, 24 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,200 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 120,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 5 million outpatient visits a year.