Incorporation of concussion history as part of the LIfestyle for BRAin Health (LIBRA) modifiable factors risk score and associations with cognition in older former National Football League players
Benjamin L. Brett, Neelum T. Aggarwal, Avinash Chandran, Zachary Y. Kerr, Samuel R. Walton, J.D. DeFreese, Kevin M. Guskiewicz, Ruben J. Echemendía, William P. Meehan, Michael McCrea, Rebekah Mannix
Abstract
Abstract Objective Investigate associations between the LIfestyle for BRAin Health (LIBRA) risk score with odds of mild cognitive impairment (MCI) diagnosis and cognitive function, incorporating concussion history. Methods Former National Football League (NFL) players ( N = 1050; mean age = 64.8 ± 9.0‐years) completed initial testing for integration of concussion history into LIBRA scores (i.e., modified‐LIBRA) and completed the Brief Test of Adult Cognition by Telephone (BTACT). Modified‐LIBRA score (including concussion history) associations with odds of MCI and cognitive dysfunction were assessed via logistic and linear regression. Results The highest quartile LIBRA scores were six times more likely to have a diagnosis of MCI compared to the lowest quartile (OR = 6.27[3.61, 10.91], p < 0.001). Modified‐LIBRA scores significantly improved model fit for odds of MCI above original LIBRA scores ( χ 2 (1) = 7.76, p = 0.005) and accounted for a greater fraction of variance in executive function (Δ R 2 = 0.02, p = 0.003) and episodic memory (Δ R 2 = 0.02, p = 0.002). Conclusions Modified‐LIBRA score, incorporating concussion history, may help monitoring risk status in former contact sport athletes, by targeting modifiable, lifestyle‐related risk factors.