The cumulative effects of a collegiate athletic career on general health measures: findings from the CARE Consortium

Objective: The acute effects of concussion and head impacts in collegiate student-athletes have been characterized, but not the effects at career end. We investigated how lifetime concussion history, sport contact exposure, and years of primary sport participation (YoP) associate with collegiate student-athlete health at institutional-exit. Methods: Collegiate student-athletes (n = 3,663) enrolled in the CARE Consortium cohort study completed eight assessments within 1 year of institutional-exit spanning physical/behavioral, mental and cognitive health, and neurobehavioral symptoms. Separate multivariable linear regressions assessed how sport contact exposure, concussion history (number), and YoP influence questionnaire scores, adjusting for sex, Race, and self-reported athlete-identity and resiliency scores. Results: Concussion history was associated with adverse scores within certain physical/behavioral, mental, and symptom health. Contact-exposed student-athletes reported improved scores on some cognitive, mental, and symptom health assessments. Greater YoP was associated with improved scores on two mental health questionnaires. Conclusions: Lifetime concussion history is associated with self-reported health outcomes at institutional-exit, though small effect sizes suggest limited clinical consequence. Higher contact-exposure sports and increased YoP were associated with improved scores on some clinical measures. Further longitudinal monitoring is encouraged to evaluate health-related changes over time, to support student-athletes as they transition out of collegiate sports.