Neuropsychology Review

, Volume 26, Issue 4, pp 340–363 | Cite as

Factors Influencing Clinical Correlates of Chronic Traumatic Encephalopathy (CTE): a Review

  • Breton M. AskenEmail author
  • Molly J. Sullan
  • Aliyah R. Snyder
  • Zachary M. Houck
  • Vaughn E. Bryant
  • Loren P. Hizel
  • Molly E. McLaren
  • Duane E. Dede
  • Michael S. Jaffee
  • Steven T. DeKosky
  • Russell M. Bauer


Chronic traumatic encephalopathy (CTE) is a neuropathologically defined disease reportedly linked to a history of repetitive brain trauma. As such, retired collision sport athletes are likely at heightened risk for developing CTE. Researchers have described distinct pathological features of CTE as well a wide range of clinical symptom presentations, recently termed traumatic encephalopathy syndrome (TES). These clinical symptoms are highly variable, non-specific to individuals described as having CTE pathology in case reports, and are often associated with many other factors. This review describes the cognitive, emotional, and behavioral changes associated with 1) developmental and demographic factors, 2) neurodevelopmental disorders, 3) normal aging, 4) adjusting to retirement, 5) drug and alcohol abuse, 6) surgeries and anesthesia, and 7) sleep difficulties, as well as the relationship between these factors and risk for developing dementia-related neurodegenerative disease. We discuss why some professional athletes may be particularly susceptible to many of these effects and the importance of choosing appropriate controls groups when designing research protocols. We conclude that these factors should be considered as modifiers predominantly of the clinical outcomes associated with repetitive brain trauma within a broader biopsychosocial framework when interpreting and attributing symptom development, though also note potential effects on neuropathological outcomes. Importantly, this could have significant treatment implications for improving quality of life.


CTE Brain injury Repetitive brain trauma Concussion Chronic traumatic encephalopathy Biopsychosocial 


  1. Alaranta, A., Alaranta, H., & Helenius, I. (2008). Use of prescription drugs in athletes. Sports Medicine, 38(6), 449–463.CrossRefPubMedGoogle Scholar
  2. Alexander, S., Kerr, M. E., Yonas, H., & Marion, D. W. (2004). The effects of admission alcohol level on cerebral blood flow and outcomes after severe traumatic brain injury. Journal of Neurotrauma, 21(5), 575–583. doi: 10.1089/089771504774129900.CrossRefPubMedGoogle Scholar
  3. Amato, P. R., & Zuo, J. (1992). Rural poverty, urban poverty, and psychological well-being. Sociological Quarterly, 33(2), 229–240.Google Scholar
  4. American Psychological Association, (2003). Diagnostic and statistical manual of mental disorders:: DSM-5: ManMag.Google Scholar
  5. Ancelin, M.-L., De Roquefeuil, G., Scali, J., Bonnel, F., Adam, J.-F., Cheminal, J.-C.,…Ritchie, K. (2010). Long-term post-operative cognitive decline in the elderly: the effects of anesthesia type, apolipoprotein E genotype, and clinical antecedents. Journal of Alzheimer’s Disease, 22, 105.Google Scholar
  6. Andersson, H. W., Sommerfelt, K., Sonnander, K., & Ahlsten, G. (1996). Maternal child-rearing attitudes, IQ, and socioeconomic status as related to cognitive abilities of five-year-old children. Psychological Reports, 79(1), 3–14. doi: 10.2466/pr0.1996.79.1.3.CrossRefPubMedGoogle Scholar
  7. Andrews-Hanna, J. R., Snyder, A. Z., Vincent, J. L., Lustig, C., Head, D., Raichle, M. E., & Buckner, R. L. (2007). Disruption of large-scale brain systems in advanced aging. Neuron, 56(5), 924–935. doi: 10.1016/j.neuron.2007.10.038.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Antonijevic, I., & Antonijevic, I. (2008). HPA axis and sleep: identifying subtypes of major depression: review. Stress, 11(1), 15–27.CrossRefPubMedGoogle Scholar
  9. Avidan, M. S., & Evers, A. S. (2011). Review of clinical evidence for persistent cognitive decline or incident dementia attributable to surgery or general anesthesia. Journal of Alzheimer's Disease, 24(2), 201.PubMedGoogle Scholar
  10. Ball, K., Berch, D. B., Helmers, K. F., Jobe, J. B., Leveck, M. D., Marsiske, M.,…Tennstedt, S. L. (2002). Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA, 288(18), 2271–2281.Google Scholar
  11. Barbaresi, W., Katusic, S., Colligan, R., Weaver, A., Pankratz, V., Mrazek, D., & Jacobsen, S. (2004). How common is attention‐deficit/hyperactivity disorder? Towards resolution of the controversy: results from a population‐based study. Acta Paediatrica, 93(s445), 55–59.PubMedGoogle Scholar
  12. Barkley, R. A. (2010). Differential diagnosis of adults with ADHD: the role of executive function and self-regulation. The Journal of Clinical Psychiatry, 71(7), e17. doi: 10.4088/JCP.9066tx1c.
  13. Beach, T. G., Monsell, S. E., Phillips, L. E., & Kukull, W. (2012). Accuracy of the clinical diagnosis of Alzheimer disease at National Institute on Aging Alzheimer Disease Centers, 2005–2010. Journal of Neuropathology and Experimental Neurology, 71(4), 266–273. doi: 10.1097/NEN.0b013e31824b211b.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Belson, K. (2011). Ex-players suing N.F.L. Over use of painkiller. Retrieved January 18, 2016, from
  15. Beresford, T. P., Arciniegas, D. B., Alfers, J., Clapp, L., Martin, B., Du, Y.,…Davatzikos, C. (2006). Hippocampus volume loss due to chronic heavy drinking. Alcoholism, Clinical and Experimental Research, 30(11), 1866–1870. doi: 10.1111/j.1530-0277.2006.00223.x.
  16. Berger, M., Nadler, J. W., Friedman, A., McDonagh, D. L., Bennett, E. R., Cooter, M.,…MAD-PIA trial team (2016). The effect of propofol versus isoflurane anesthesia on human cerebrospinal fluid markers of Alzheimer’s Disease: Results of a Randomized Trial. Journal of Alzheimer’s Disease, 52(4), 1299–1310. doi: 10.3233/JAD-151190.
  17. Biederman, J., Monuteaux, M. C., Mick, E., Spencer, T., Wilens, T. E., Silva, J. M.,…Faraone, S. V. (2006). Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Psychological Medicine, 36(02), 167–179.Google Scholar
  18. Bieniek, K. F., Ross, O. A., Cormier, K. A., Walton, R. L., Soto-Ortolaza, A., Johnston, A. E.,… Dickson, D. W. (2015). Chronic traumatic encephalopathy pathology in a neurodegenerative disorders brain bank. Acta Neuropathologica, 130(6), 877–889. doi:  10.1007/s00401-015-1502-4.
  19. Bilottaa, F., Doronzioa, A., Stazia, E., & Fodaleb, L. T. V. (2010). Postoperative cognitive dysfunction: toward the Alzheimer’s disease pathomechanism hypothesis. Apoptosis, 22, 25.Google Scholar
  20. Blair, K., Smith, B., Mitchell, D., Morton, J., Vythilingam, M., Pessoa, L.,… Drevets, W. (2007). Modulation of emotion by cognition and cognition by emotion. Neuroimage, 35(1), 430–440.Google Scholar
  21. Blaylock, R. L., & Maroon, J. (2011). Immunoexcitotoxicity as a central mechanism in chronic traumatic encephalopathy—a unifying hypothesis. Surgical Neurology International, 2.Google Scholar
  22. Borenstein, A. R., Copenhaver, C. I., & Mortimer, J. A. (2006). Early-life risk factors for Alzheimer’s disease. Alzheimer Disease and Associated Disorders, 20(1), 63–72. doi: 10.1097/01.wad.0000201854.62116.d7.CrossRefPubMedGoogle Scholar
  23. Bradley, R. H., & Corwyn, R. F. (2002). Socioeconomic status and child development. Annual Review of Psychology, 53, 371–399. doi: 10.1146/annurev.psych.53.100901.135233.CrossRefPubMedGoogle Scholar
  24. Bramham, J., Murphy, D., Xenitidis, K., Asherson, P., Hopkin, G., & Young, S. (2012). Adults with attention deficit hyperactivity disorder: an investigation of age-related differences in behavioural symptoms, neuropsychological function and co-morbidity. Psychological Medicine, 42(10), 2225–2234.CrossRefPubMedGoogle Scholar
  25. Braveman, P. A., Cubbin, C., Egerter, S., Chideya, S., Marchi, K. S., Metzler, M., & Posner, S. (2005). Socioeconomic status in health research: one size does not fit all. JAMA, 294(22), 2879–2888. doi: 10.1001/jama.294.22.2879.CrossRefPubMedGoogle Scholar
  26. Butters, N., & Stuss, D. T. (1989). Diencephalic amnesia. Handbook of Neuropsychology, 3, 107–148.Google Scholar
  27. Butters, M. A., Young, J. B., Lopez, O., Aizenstein, H. J., Mulsant, B. H., Reynolds III, C. F.,…Becker, J. T. (2008). Pathways linking late-life depression to persistent cognitive impairment and dementia. Dialogues in Clinical Neuroscience, 10(3), 345–357.Google Scholar
  28. Buysse, D. J. (2004). Insomnia, depression and aging. Assessing sleep and mood interactions in older adults. Geriatrics, 59(2), 47–51. quiz 52.PubMedGoogle Scholar
  29. Calvo, E., Sarkisian, N., & Tamborini, C. R. (2013). Causal effects of retirement timing on subjective physical and emotional health. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 68(1), 73–84.CrossRefGoogle Scholar
  30. Campbell, L. (2011). For retired NFL players, most challening ‘season’ just beginning. from
  31. Caraci, F., Pistara, V., Corsaro, A., Tomasello, F., Giuffrida, M. L., Sortino, M. A.,…Copani, A. (2011). Neurotoxic properties of the anabolic androgenic steroids nandrolone and methandrostenolone in primary neuronal cultures. Journal Neuroscience Research, 89(4), 592–600. doi:  10.1002/jnr.22578
  32. Carter, M. A. T., & Cook, K. (1995). Adaptation to retirement: role changes and psychological resources. The Career Development Quarterly, 44(1), 67–82.CrossRefGoogle Scholar
  33. Casey, B., Trainor, R. J., Orendi, J. L., Schubert, A. B., Nystrom, L. E., Giedd, J. N.,…Cohen, J. D. (1997). A developmental functional MRI study of prefrontal activation during performance of a go-no-go task. Journal of Cognitive Neuroscience, 9(6), 835–847.Google Scholar
  34. Chapman, S. L., Byas-Smith, M. G., & Reed, B. A. (2002). Effects of intermediate- and long-term use of opioids on cognition in patients with chronic pain. The Clinical Journal of Pain, 18(4 Suppl), S83–S90.CrossRefPubMedGoogle Scholar
  35. Chen, C.-W., Lin, C.-C., Chen, K.-B., Kuo, Y.-C., Li, C.-Y., & Chung, C.-J. (2014). Increased risk of dementia in people with previous exposure to general anesthesia: a nationwide population-based case–control study. Alzheimer's & Dementia, 10(2), 196–204.CrossRefGoogle Scholar
  36. Choi, P., Parrott, A., & Cowan, D. (1990). High dose anabolic steroids in strength athletes: effects upon hostility and aggression. Human Psychopharmacology: Clinical and Experimental, 5(4), 349–356.CrossRefGoogle Scholar
  37. Chugani, H. T. (1998). A critical period of brain development: studies of cerebral glucose utilization with PET. Preventive Medicine, 27(2), 184–188.CrossRefPubMedGoogle Scholar
  38. Cipriani, G., Lucetti, C., Danti, S., & Nuti, A. (2015). Sleep disturbances and dementia. Psychogeriatrics, 15(1), 65–74. doi: 10.1111/psyg.12069.CrossRefPubMedGoogle Scholar
  39. Collins, M. W., Grindel, S. H., Lovell, M. R., Dede, D. E., Moser, D. J., Phalin, B. R.,…McKeag, D. B. (1999). Relationship between concussion and neuropsychological performance in college football players. JAMA, 282(10), 964–970.Google Scholar
  40. Conger, R. D., & Donnellan, M. B. (2007). An interactionist perspective on the socioeconomic context of human development. Annual Review of Psychology, 58, 175–199.CrossRefPubMedGoogle Scholar
  41. Corben, B. (Writer). (2012). 30 for 30: Broke, 30 for 30: Broke: Entertainment and Sports Programming Network [ESPN].Google Scholar
  42. Cottler, L. B., Ben Abdallah, A., Cummings, S. M., Barr, J., Banks, R., & Forchheimer, R. (2011). Injury, pain, and prescription opioid use among former National Football League (NFL) players. Drug and Alcohol Dependence, 116(1–3), 188–194. doi: 10.1016/j.drugalcdep.2010.12.003.CrossRefPubMedPubMedCentralGoogle Scholar
  43. Coughlin, J. M., Wang, Y., Munro, C. A., Ma, S., Yue, C., Chen, S.,…Pomper, M. G. (2015). Neuroinflammation and brain atrophy in former NFL players: An in vivo multimodal imaging pilot study. Neurobiology of Disease, 74, 58–65. doi: 10.1016/j.nbd.2014.10.019.
  44. Crane, P. K., Gibbons, L. E., Dams-O’Connor, K., et al. (2016). Association of traumatic brain injury with late-life neurodegenerative conditions and neuropathologic findings. JAMA Neurology. doi: 10.1001/jamaneurol.2016.1948.Google Scholar
  45. Crary, J. F., Trojanowski, J. Q., Schnieder, J. A., Abisambra, J. F., Abner, E. L., Alafuzoff, I.,…Nelson, P. T. (2014). Primary age-related tauopathy (PART): a common pathology associated with human aging. Acta Neuropathologica, 128(6), 755–766. doi: 10.1007/s00401-014-1349-0.
  46. Dave, D., Rashad, I., & Spasojevic, J. (2006). The effects of retirement on physical and mental health outcomes: National Bureau of Economic Research.Google Scholar
  47. Davison, L., Steinhelber, J., Eger, E., 2nd, & Stevens, W. (1975). Psychological effects of halothane and isoflurane anesthesia. Anesthesiology, 43(3), 313–324.CrossRefPubMedGoogle Scholar
  48. de Jong, P. F. (1998). Working memory deficits of reading disabled children. Journal of Experimental Child Psychology, 70(2), 75–96.CrossRefPubMedGoogle Scholar
  49. Deiner, S., & Silverstein, J. H. (2009). Postoperative delirium and cognitive dysfunction. British Journal of Anaesthesia, 103(Suppl 1), i41–i46. doi: 10.1093/bja/aep291.CrossRefPubMedPubMedCentralGoogle Scholar
  50. den Boer, J. J., Oostendorp, R. A., Beems, T., Munneke, M., Oerlemans, M., & Evers, A. W. (2006). A systematic review of bio-psychosocial risk factors for an unfavourable outcome after lumbar disc surgery. European Spine Journal, 15(5), 527–536.CrossRefGoogle Scholar
  51. Diekelmann, S., & Born, J. (2010). The memory function of sleep. Nature Reviews. Neuroscience, 11(2), 114–126.PubMedGoogle Scholar
  52. Dimoula, F., Torregrosa, M., Psychountaki, M., & Fernandez, M. D. (2013). Retiring from elite sports in Greece and Spain. The Spanish Journal of Psychology, 16, E38. doi: 10.1017/sjp.2013.18.PubMedGoogle Scholar
  53. Dodge, K. A., & Pettit, G. S. (2003). A biopsychosocial model of the development of chronic conduct problems in adolescence. Developmental Psychology, 39(2), 349.CrossRefPubMedPubMedCentralGoogle Scholar
  54. Downer, B., Jiang, Y., Zanjani, F., & Fardo, D. (2015). Effects of alcohol consumption on cognition and regional brain volumes among older adults. American Journal of Alzheimer's Disease and Other Dementias, 30(4), 364–374. doi: 10.1177/1533317514549411.CrossRefPubMedGoogle Scholar
  55. Dufouil, C., Pereira, E., Chene, G., Glymour, M. M., Alperovitch, A., Saubusse, E.,…Forette, F. (2014). Older age at retirement is associated with decreased risk of dementia. European Journal of Epidemiology, 29(5), 353–361. doi: 10.1007/s10654-014-9906-3.
  56. Duncan, G. J., Brooks-Gunn, J., & Klebanov, P. K. (1994). Economic deprivation and early childhood development. Child Development, 65(2), 296–318.CrossRefPubMedGoogle Scholar
  57. Durmer, J. S., & Dinges, D. F. (2005). Neurocognitive consequences of sleep deprivation. Seminars in Neurology, 25(1), 117–129. doi: 10.1055/s-2005-867080.CrossRefPubMedGoogle Scholar
  58. Estrada, M., Varshney, A., & Ehrlich, B. E. (2006). Elevated testosterone induces apoptosis in neuronal cells. The Journal of Biological Chemistry, 281(35), 25492–25501. doi: 10.1074/jbc.M603193200.CrossRefPubMedGoogle Scholar
  59. Evans, G. W. (2006). Child development and the physical environment. Annual Review of Psychology, 57, 423–451. doi: 10.1146/annurev.psych.57.102904.190057.CrossRefPubMedGoogle Scholar
  60. Farrell-Carnahan, L., Franke, L., Graham, C., & McNamee, S. (2013). Subjective sleep disturbance in veterans receiving care in the veterans affairs polytrauma system following blast-related mild traumatic brain injury. Military Medicine, 178(9), 951–956. doi: 10.7205/MILMED-D-13-00037.CrossRefPubMedGoogle Scholar
  61. Feeley, B. T., Kennelly, S., Barnes, R. P., Muller, M. S., Kelly, B. T., Rodeo, S. A., & Warren, R. F. (2008). Epidemiology of National Football League training camp injuries from 1998 to 2007. The American Journal of Sports Medicine, 36(8), 1597–1603.CrossRefPubMedGoogle Scholar
  62. Fiske, A., Wetherell, J. L., & Gatz, M. (2009). Depression in older adults. Annual Review of Clinical Psychology, 5, 363–389. doi: 10.1146/annurev.clinpsy.032408.153621.CrossRefPubMedPubMedCentralGoogle Scholar
  63. Fjell, A. M., & Walhovd, K. B. (2010). Structural brain changes in aging: courses, causes and cognitive consequences. Reviews in the Neurosciences, 21, 187.CrossRefPubMedGoogle Scholar
  64. Fleminger, S., Oliver, D. L., Lovestone, S., Rabe-Hesketh, S., & Giora, A. (2003). Head injury as a risk factor for Alzheimer’s disease: the evidence 10 years on; a partial replication. Journal of Neurology, Neurosurgery, and Psychiatry, 74(7), 857–862.CrossRefPubMedPubMedCentralGoogle Scholar
  65. Fong, T. G., Hshieh, T. T., Wong, B., Tommet, D., Jones, R. N., Schmitt, E. M.,…Inouye, S. K. (2015). Neuropsychological profiles of an elderly cohort undergoing elective surgery and the relationship between cognitive performance and delirium. Journal of the American Geriatrics Society, 63(5), 977–982. doi: 10.1111/jgs.13383.
  66. Fralick, M., Thiruchelvam, D., Tien, H. C., & Redelmeier, D. A. (2016). Risk of suicide after a concussion. CMAJ, 188(7), 497–504. doi: 10.1503/cmaj.150790.CrossRefPubMedPubMedCentralGoogle Scholar
  67. Fulda, S., & Schulz, H. (2001). Cognitive dysfunction in sleep disorders. Sleep Medicine Reviews, 5(6), 423–445.CrossRefPubMedGoogle Scholar
  68. Garcia-Lorenzo, D., Longo-Dos Santos, C., Ewenczyk, C., Leu-Semenescu, S., Gallea, C., Quattrocchi, G.,…Lehericy, S. (2013). The coeruleus/subcoeruleus complex in rapid eye movement sleep behaviour disorders in Parkinson’s disease. Brain, 136(Pt 7), 2120–2129. doi: 10.1093/brain/awt152.
  69. Gardner, R. C., & Yaffe, K. (2015). Epidemiology of mild traumatic brain injury and neurodegenerative disease. Molecular and Cellular Neuroscience, 66, 75–80.CrossRefPubMedPubMedCentralGoogle Scholar
  70. Gardner, A., Iverson, G. L., & McCrory, P. (2013). Chronic traumatic encephalopathy in sport: a systematic review. British Journal of Sports Medicine, 48(2), 84–90. doi: 10.1136/bjsports-2013-092646.
  71. Gardner, R. C., Burke, J. F., Nettiksimmons, J., Kaup, A., Barnes, D. E., & Yaffe, K. (2014). Dementia risk after traumatic brain injury vs. nonbrain trauma: the role of age and severity. JAMA Neurology, 71(12), 1490–1497. doi: 10.1001/jamaneurol.2014.2668.CrossRefPubMedPubMedCentralGoogle Scholar
  72. Gardner, R. C., Possin, K. L., Hess, C. P., Huang, E. J., Grinberg, L. T., Nolan, A. L.,…Rabinovici, G. D. (2015). Evaluating and treating neurobehavioral symptoms in professional American football players: lessons from a case series. Neurological Clinical Practice, 5(4), 285–295, doi: 10.1212/CPJ.0000000000000157.
  73. Gavett, B. E., Cantu, R. C., Shenton, M., Lin, A. P., Nowinski, C. J., McKee, A. C., & Stern, R. A. (2011). Clinical appraisal of chronic traumatic encephalopathy: current perspectives and future directions. Current Opinion in Neurology, 24(6), 525–531.CrossRefPubMedGoogle Scholar
  74. Geddes, J. F., Vowles, G. H., Nicoll, J. A., & Revesz, T. (1999). Neuronal cytoskeletal changes are an early consequence of repetitive head injury. [Case Reports]. Acta Neuropathologica, 98(2), 171–178.CrossRefPubMedGoogle Scholar
  75. Germain, A., Nofzinger, E. A., Kupfer, D. J., & Buysse, D. J. (2004). Neurobiology of non-REM sleep in depression: further evidence for hypofrontality and thalamic dysregulation. The American Journal of Psychiatry, 161(10), 1856–1863. doi: 10.1176/ajp.161.10.1856.CrossRefPubMedGoogle Scholar
  76. Giza, C. C., & Hovda, D. A. (2014). The new neurometabolic cascade of concussion. Neurosurgery, 75(Suppl 4), S24–S33. doi: 10.1227/NEU.0000000000000505.CrossRefPubMedPubMedCentralGoogle Scholar
  77. Goldstein, G., Beers, S. R., Siegel, D. J., & Minshew, N. J. (2001). A comparison of WAIS-R profiles in adults with high-functioning autism or differing subtypes of learning disability. Applied Neuropsychology, 8(3), 148–154.CrossRefPubMedGoogle Scholar
  78. Golimstok, A., Rojas, J., Romano, M., Zurru, M., Doctorovich, D., & Cristiano, E. (2011). Previous adult attention‐deficit and hyperactivity disorder symptoms and risk of dementia with Lewy bodies: a case–control study. European Journal of Neurology, 18(1), 78–84.CrossRefPubMedGoogle Scholar
  79. Gottfried, A. W. (1985). Measures of socioeconomic status in child development research: data and recommendations. Merrill-Palmer Quaterly (1982-), 31(1), 85–92.Google Scholar
  80. Grant, I. (1987). Alcohol and the brain: neuropsychological correlates. Journal of Consulting and Clinical Psychology, 55(3), 310.CrossRefPubMedGoogle Scholar
  81. Grattan, A., Sullivan, M. D., Saunders, K. W., Campbell, C. I., & Von Korff, M. R. (2012). Depression and prescription opioid misuse among chronic opioid therapy recipients with no history of substance abuse. The Annals of Family Medicine, 10(4), 304–311.CrossRefPubMedGoogle Scholar
  82. Gregory, A. M., Van der Ende, J., Willis, T. A., & Verhulst, F. C. (2008). Parent-reported sleep problems during development and self-reported anxiety/depression, attention problems, and aggressive behavior later in life. Archives of Pediatrics & Adolescent Medicine, 162(4), 330–335.CrossRefGoogle Scholar
  83. Guskiewicz, K., Marshall, S. W., Bailes, J., Mccrea, M., Harding, H. P., Matthews, A.,…Cantu, R. C. (2007). Recurrent concussion and risk of depression in retired professional football players. Medicine & Science in Sports & Exercise, 39(6), 903–909.Google Scholar
  84. Hall, K. S., Gao, S., Unverzagt, F. W., & Hendrie, H. C. (2000). Low education and childhood rural residence: risk for Alzheimer’s disease in African Americans. Neurology, 54(1), 95–99.CrossRefPubMedGoogle Scholar
  85. Hall, R. C., Hall, R. C., & Chapman, M. J. (2005). Psychiatric complications of anabolic steroid abuse. Psychosomatics, 46(4), 285–290.CrossRefPubMedGoogle Scholar
  86. Halson, S. L. (2014). Sleep in elite athletes and nutritional interventions to enhance sleep. Sports Medicine, 44(Suppl 1), S13–S23. doi: 10.1007/s40279-014-0147-0.CrossRefPubMedGoogle Scholar
  87. Haorah, J., Knipe, B., Leibhart, J., Ghorpade, A., & Persidsky, Y. (2005). Alcohol-induced oxidative stress in brain endothelial cells causes blood–brain barrier dysfunction. Journal of Leukocyte Biology, 78(6), 1223–1232. doi: 10.1189/jlb.0605340.CrossRefPubMedGoogle Scholar
  88. Hasin, D. S., & Grant, B. F. (2002). Major depression in 6050 former drinkers: association with past alcohol dependence. Archives of General Psychiatry, 59(9), 794–800.CrossRefPubMedGoogle Scholar
  89. Herrmann, L. L., Goodwin, G. M., & Ebmeier, K. P. (2007). The cognitive neuropsychology of depression in the elderly. Psychological Medicine, 37(12), 1693–1702. doi: 10.1017/S0033291707001134.CrossRefPubMedGoogle Scholar
  90. Hervey, A. S., Epstein, J. N., & Curry, J. F. (2004). Neuropsychology of adults with attention-deficit/hyperactivity disorder: a meta-analytic review. Neuropsychology, 18(3), 485.CrossRefPubMedGoogle Scholar
  91. Hildebrandt, T., Langenbucher, J. W., Flores, A., Harty, S., & Berlin, H. A. (2014). The influence of age of onset and acute anabolic steroid exposure on cognitive performance, impulsivity, and aggression in men. Psychology of Addictive Behaviors, 28(4), 1096–1104. doi: 10.1037/a0036482.CrossRefPubMedPubMedCentralGoogle Scholar
  92. Hill, P., & Lowe, B. (1974). The inevitable metathesis of the retiring athlete. International Review for the Sociology of Sport, 9(3), 5–32.CrossRefGoogle Scholar
  93. Hoaken, P. N., & Stewart, S. H. (2003). Drugs of abuse and the elicitation of human aggressive behavior. Addictive Behaviors, 28(9), 1533–1554.CrossRefPubMedGoogle Scholar
  94. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.CrossRefPubMedPubMedCentralGoogle Scholar
  95. Horn, L., & Nevill, S. (2006). Profile of undergraduate students in US postsecondary education institutions: 2003–2004: With a special analysis of community college students (NCES 2006–184). Washington, DC: US Department of Education. National Center for Education Statistics.Google Scholar
  96. Horn, S., Gregory, P., & Guskiewicz, K. M. (2009). Self-reported anabolic-androgenic steroids use and musculoskeletal injuries: findings from the center for the study of retired athletes health survey of retired NFL players. American Journal of Physical Medicine & Rehabilitation, 88(3), 192–200.CrossRefGoogle Scholar
  97. Hussain, M., Berger, M., Eckenhoff, R. G., & Seitz, D. P. (2014). General anesthetic and the risk of dementia in elderly patients: current insights. Clinical Interventions in Aging, 9, 1619–1628. doi: 10.2147/CIA.S49680.PubMedPubMedCentralGoogle Scholar
  98. Iliff, J. J., Lee, H., Yu, M., Feng, T., Logan, J., Nedergaard, M., & Benveniste, H. (2013). Brain-wide pathway for waste clearance captured by contrast-enhanced MRI. The Journal of Clinical Investigation, 123(3), 1299–1309. doi: 10.1172/jci67677.CrossRefPubMedPubMedCentralGoogle Scholar
  99. Ilyuk, R., Gromyco, D., Kiselev, A., Torban, M., & Krupitsky, E. (2013). Hostility and anger in patients dependent on different psychoactive drugs. ANS: The Journal for Neurocognitive Research, 54(3–4).Google Scholar
  100. Ivanchak, N., Fletcher, K., & Jicha, G. A. (2012). Attention-deficit/hyperactivity disorder in older adults: prevalence and possible connections to mild cognitive impairment. Current Psychiatry Reports, 14(5), 552–560.CrossRefPubMedPubMedCentralGoogle Scholar
  101. Iverson, G. L. (2014). Chronic traumatic encephalopathy and risk of suicide in former athletes. British Journal of Sports Medicine, 48(2), 162–164.CrossRefPubMedGoogle Scholar
  102. Iverson, G. L. (2016). Suicide and chronic traumatic encephalopathy. The Journal of Neuropsychiatry and Clinical Neurosciences, 28.1(1), 9–16.CrossRefGoogle Scholar
  103. Iverson, G. L., Gardner, A. J., McCrory, P., Zafonte, R., & Castellani, R. J. (2015a). A critical review of chronic traumatic encephalopathy. Neuroscience & Biobehavioral Reviews, 56, 276–293.CrossRefGoogle Scholar
  104. Iverson, G. L., Silverberg, N. D., Mannix, R., Maxwell, B. A., Atkins, J. E., Zafonte, R., & Berkner, P. D. (2015b). Factors associated with concussion-like symptom reporting in high school athletes. JAMA Pediatrics, 169(12), 1132–1140. doi: 10.1001/jamapediatrics.2015.2374.CrossRefPubMedGoogle Scholar
  105. Jafari, S., Etminan, M., Aminzadeh, F., & Samii, A. (2013). Head injury and risk for Parkinson disease: a systematic review and meta-analysis. Movement Disorders, 28(9), 1222–1229. doi: 10.1002/mds.25458.CrossRefPubMedGoogle Scholar
  106. Jaffee, M. S., Winter, W. C., Jones, C. C., & Ling, G. (2015). Sleep disturbances in athletic concussion. Brain Injury, 29(2), 221–227.CrossRefPubMedGoogle Scholar
  107. Jaussent, I., Bouyer, J., Ancelin, M. L., Berr, C., Foubert-Samier, A., Ritchie, K.,…Dauvilliers, Y. (2012). Excessive sleepiness is predictive of cognitive decline in the elderly. Sleep, 35(9), 1201–1207. doi: 10.5665/sleep.2070.
  108. Jefferis, B. J., Power, C., & Hertzman, C. (2002). Birth weight, childhood socioeconomic environment, and cognitive development in the 1958 British birth cohort study. BMJ, 325(7359), 305.CrossRefPubMedPubMedCentralGoogle Scholar
  109. Jenkins, K. R., Pienta, A. M., & Horgas, A. L. (2002). Activity and health-related quality of life in continuing care retirement communities. Research on Aging, 24(1), 124–149.CrossRefGoogle Scholar
  110. Jessen, N. A., Munk, A. S., Lundgaard, I., & Nedergaard, M. (2015). The glymphatic system: a beginner’s guide. Neurochemical Research, 40(12), 2583–2599. doi: 10.1007/s11064-015-1581-6.CrossRefPubMedGoogle Scholar
  111. Jiang, J., & Jiang, H. (2015). Effect of the inhaled anesthetics isoflurane, sevoflurane, and desflurane on the neuropathogenesis of Alzheimer’s disease (review). Molecular Medicine Reports, 12(1), 3–12. doi: 10.3892/mmr.2015.3424.PubMedPubMedCentralGoogle Scholar
  112. Jordan, B. D. (2013). The clinical spectrum of sport-related traumatic brain injury. Nature Reviews. Neurology, 9(4), 222–230.CrossRefPubMedGoogle Scholar
  113. Kamphuis, J., Meerlo, P., Koolhaas, J. M., & Lancel, M. (2012). Poor sleep as a potential causal factor in aggression and violence. Sleep Medicine, 13(4), 327–334.CrossRefPubMedGoogle Scholar
  114. Kanayama, G., Cohane, G. H., Weiss, R. D., & Pope, H. G. (2003). Past anabolic-androgenic steroid use among men admitted for substance abuse treatment: an underrecognized problem? The Journal of Clinical Psychiatry, 64(2), 156–160.CrossRefPubMedGoogle Scholar
  115. Kanayama, G., Kean, J., Hudson, J. I., & Pope, H. G., Jr. (2013). Cognitive deficits in long-term anabolic-androgenic steroid users. Drug and Alcohol Dependence, 130(1–3), 208–214. doi: 10.1016/j.drugalcdep.2012.11.008.CrossRefPubMedGoogle Scholar
  116. Kaplan, G. A., Turrell, G., Lynch, J. W., Everson, S. A., Helkala, E. L., & Salonen, J. T. (2001). Childhood socioeconomic position and cognitive function in adulthood. International Journal of Epidemiology, 30(2), 256–263.CrossRefPubMedGoogle Scholar
  117. Kaufman, M. J., Janes, A. C., Hudson, J. I., Brennan, B. P., Kanayama, G., Kerrigan, A. R.,…Pope, H. G., Jr. (2015). Brain and cognition abnormalities in long-term anabolic-androgenic steroid users. Drug and Alcohol Dependence, 152, 47–56. doi: 10.1016/j.drugalcdep.2015.04.023.
  118. Kerr, Z. Y., Marshall, S. W., Harding, H. P., Jr., & Guskiewicz, K. M. (2012). Nine-year risk of depression diagnosis increases with increasing self-reported concussions in retired professional football players. The American Journal of Sports Medicine. doi: 10.1177/0363546512456193.PubMedGoogle Scholar
  119. Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O.,…Secnik, K. (2006). The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of Psychiatry.Google Scholar
  120. Kiecolt-Glaser, J. K., Page, G. G., Marucha, P. T., MacCallum, R. C., & Glaser, R. (1998). Psychological influences on surgical recovery: perspectives from psychoneuroimmunology. American Psychologist, 53(11), 1209.CrossRefPubMedGoogle Scholar
  121. Klerman, L. V. (1991). Alive and well? A research and policy review of health programs for poor young children: ERIC.Google Scholar
  122. Korenman, S., Miller, J. E., & Sjaastad, J. E. (1995). Long-term poverty and child development in the United States: results from the NLSY. Children and Youth Services Review, 17(1), 127–155.CrossRefGoogle Scholar
  123. Kress, B. T., Iliff, J. J., Xia, M., Wang, M., Wei, H. S., Zeppenfeld, D.,…Nedergaard, M. (2014). Impairment of paravascular clearance pathways in the aging brain. Annals of Neurology, 76(6), 845–861. doi: 10.1002/ana.24271.
  124. Lahey, B. B., Loeber, R., Hart, E. L., Frick, P. J., Applegate, B., Zhang, Q.,…Russo, M. F. (1995). Four-year longitudinal study of conduct disorder in boys: patterns and predictors of persistence. Journal of Abnormal Psychology, 104(1), 83.Google Scholar
  125. Lastella, M., Roach, G. D., Halson, S. L., & Sargent, C. (2015). Sleep/wake behaviours of elite athletes from individual and team sports. European Journal of Sport Science, 15(2), 94–100. doi: 10.1080/17461391.2014.932016.CrossRefPubMedGoogle Scholar
  126. Lavallee, D., Grove, J. R., & Gordon, S. (1997). The causes of career termination from sport and their relationship to post-retirement adjustment among elite-amateur athletes in Australia. Australian Psychologist, 32(2), 131–135.CrossRefGoogle Scholar
  127. Lehman, E. J., Hein, M. J., Baron, S. L., & Gersic, C. M. (2012). Neurodegenerative causes of death among retired National Football League players. Neurology, 79(19), 1970–1974.CrossRefPubMedPubMedCentralGoogle Scholar
  128. Lehman, E.J., Hein, M.J., & Gersic, C. M. (2016). Suicide mortality among retired National Football League players who played 5 or more seasons. The American Journal of Sports Medicine. Google Scholar
  129. Liguori, C., Romigi, A., Nuccetelli, M., Zannino, S., Sancesario, G., Martorana, A.,…Placidi, F. (2014). Orexinergic system dysregulation, sleep impairment, and cognitive decline in Alzheimer disease. JAMA Neurology, 71(12), 1498–1505. doi: 10.1001/jamaneurol.2014.2510.
  130. Lule, D., Ludolph, A., & Ludolph, A. (2008). Neurodevelopmental and neurodegenerative diseases–Is there a pathophysiological link? Attention-deficit/hyperactivity disorder and amyotrophic lateral sclerosis as examples. Medical Hypotheses, 70(6), 1133–1138.CrossRefPubMedGoogle Scholar
  131. Luo, Y., & Waite, L. J. (2005). The impact of childhood and adult SES on physical, mental, and cognitive well-being in later life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60(2), S93–S101.CrossRefPubMedCentralGoogle Scholar
  132. Lupien, S. J., de Leon, M., De Santi, S., Convit, A., Tarshish, C., Nair, N. P. V.,…Meaney, M. J. (1998). Cortisol levels during human aging predict hippocampal atrophy and memory deficits. Nature Neuroscience, 1(1), 69–73.Google Scholar
  133. Lynch, J. W., Kaplan, G. A., & Shema, S. J. (1997). Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. The New England Journal of Medicine, 337(26), 1889–1895. doi: 10.1056/NEJM199712253372606.CrossRefPubMedGoogle Scholar
  134. Madden, D., Bennett, I., & Song, A. (2009). Cerebral white matter integrity and cognitive aging: contributions from diffusion tensor imaging. Neuropsychology Review, 19(4), 415–435. doi: 10.1007/s11065-009-9113-2.CrossRefPubMedPubMedCentralGoogle Scholar
  135. Major League Soccer Racial and Gender Report Card. (2015). The Institute for Diversity and Ethics in Sport. from
  136. Manchikanti, L., Giordano, J., Boswell, M. V., Fellows, B., Manchukonda, R., & Pampati, B. (2007). Psychological factors as predictors of opioid abuse and illicit drug use in chronic pain patients. Journal of Management, 5, 8.Google Scholar
  137. Mander, B. A., Rao, V., Lu, B., Saletin, J. M., Lindquist, J. R., Ancoli-Israel, S.,…Walker, M. P. (2013). Prefrontal atrophy, disrupted NREM slow waves and impaired hippocampal-dependent memory in aging. Nature Neuroscience, 16(3), 357–364. doi: 10.1038/nn.3324.
  138. Manly, J. J., & Echemendia, R. J. (2007). Race-specific norms: using the model of hypertension to understand issues of race, culture, and education in neuropsychology. Archives of Clinical Neuropsychology, 22(3), 319–325.CrossRefPubMedGoogle Scholar
  139. Manly, J. J., Jacobs, D. M., Touradji, P., Small, S. A., & Stern, Y. (2002). Reading level attenuates differences in neuropsychological test performance between African American and White elders. Journal of the International Neuropsychological Society, 8(3), 341–348.CrossRefPubMedGoogle Scholar
  140. Marion, M.-H., Qurashi, M., Marshall, G., & Foster, O. (2008). Is REM sleep behaviour disorder (RBD) a risk factor of dementia in idiopathic Parkinson’s disease? Journal of Neurology, 255(2), 192–196.CrossRefPubMedGoogle Scholar
  141. Martland, H. (1928). Dementia pugilistica. JAMA, 91, 1103–1107.CrossRefGoogle Scholar
  142. McCann, B., & Roy-Byrne, P. (2000). Attention-deficit/hyperactivity disorder and learning disabilities in adults. Paper presented at the Seminars in clinical neuropsychiatry.Google Scholar
  143. McCrea, M., Broshek, D. K., & Barth, J. T. (2015). Sports concussion assessment and management: future research directions. Brain Injury, 29(2), 276–282. doi: 10.3109/02699052.2014.965216.CrossRefPubMedGoogle Scholar
  144. McCrory, P., Meeuwisse, W. H., Kutcher, J. S., Jordan, B. D., & Gardner, A. (2013). What is the evidence for chronic concussion-related changes in retired athletes: behvaioural, pathological, and clinical outcomes? British Journal of Sports Medicine, 47(5), 327–330.CrossRefPubMedGoogle Scholar
  145. McKee, A. C., Cantu, R. C., Nowinski, C. J., Hedley-Whyte, E. T., Gavett, B. E., Budson, A. E.,…Stern, R. A. (2009). Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. Journal of Neuropathology and Experimental Neurology, 68(7), 709–735. doi: 10.1097/NEN.0b013e3181a9d503.
  146. McKee, A. C., Stein, T. D., Nowinski, C. J., Stern, R. A., Daneshvar, D. H., Alvarez, V. E.,…Baugh, C. M. (2013). The spectrum of disease in chronic traumatic encephalopathy. Brain, 136(1), 43–64.Google Scholar
  147. McKee, A.C., Cairns, N.J., Dickson, D.W., Folkerth, R.D., Keene, C.D., Litvan, I.,…TBI/CTE group (2016). The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Acta Neuropathology, 131(1), 75–86. doi: 10.1007/s00401-015-1515-z.
  148. McLoyd, V. C. (1997). The impact of poverty and low socioeconomic status on the socioemotional functioning of African-American children and adolescents: Mediating effects. Social and Emotional Adjustment and Family Relations in Ethnic Minority Families, 7–34.Google Scholar
  149. Meck, W. H., Williams, C. L., Cermak, J. M., & Blusztajn, J. K. (2007). Developmental periods of choline sensitivity provide an ontogenetic mechanism for regulating memory capacity and age-related dementia. Frontiers in Integrative Neuroscience, 1.Google Scholar
  150. Mendelsohn, A. R., & Larrick, J. W. (2013). Sleep facilitates clearance of metabolites from the brain: glymphatic function in aging and neurodegenerative diseases. Rejuvenation Research, 16(6), 518–523. doi: 10.1089/rej.2013.1530.CrossRefPubMedGoogle Scholar
  151. Mez, J., Solomon, T., Daneshvar, D. H., Stein, T. D., & McKee, A. C. (2016). Pathologically confirmed chronic traumatic encephalopathy in a 25-year-old former college football player. JAMA Neurology, Online First. doi: 10.1001/jamaneurol.2015.3998.Google Scholar
  152. Miles, K. (2012). Armond Armstead, Former USC Football Player, sues school for heart attack. from
  153. Mills, J. D., Bailes, J. E., Turner, R. C., Dodson, S. C., Sakai, J., & Maroon, J. C. (2012). Anabolic steroids and head injury. Neurosurgery, 70(1), 205–210.CrossRefPubMedGoogle Scholar
  154. Millspaugh, J. (1937). Dementia pugilistica. United States Naval Medical Bulletin, 35, 297–303.Google Scholar
  155. Minkel, J. D., Banks, S., Htaik, O., Moreta, M. C., Jones, C. W., McGlinchey, E. L.,…Dinges, D. F. (2012). Sleep deprivation and stressors: evidence for elevated negative affect in response to mild stressors when sleep deprived. Emotion, 12(5), 1015–1020. doi: 10.1037/a0026871.
  156. Moceri, V. M., Kukull, W. A., Emanuel, I., van Belle, G., & Larson, E. B. (2000). Early-life risk factors and the development of Alzheimer’s disease. Neurology, 54(2), 415–420.CrossRefPubMedGoogle Scholar
  157. Monk, T. G., & Price, C. C. (2011). Postoperative cognitive disorders. Current Opinion in Critical Care, 17(4).Google Scholar
  158. Monk, T. G., Weldon, B. C., Garvan, C. W., Dede, D. E., Van Der Aa, M. T., Heilman, K. M., & Gravenstein, J. S. (2008). Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology-Philadelphia Then Hagerstown, 108(1), 18.CrossRefGoogle Scholar
  159. Montenigro, P. H., Baugh, C. M., Daneshvar, D. H., Mez, J., Budson, A. E., Au, R.,…Stern, R. A. (2014). Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome. Alzheimer’s Research & Therapy, 6(5), 68.Google Scholar
  160. Mortimer, J. A., van Duijn, C. M., Chandra, V., Fratiglioni, L., Graves, A. B., Heyman, A.,…et al. (1991). Head trauma as a risk factor for Alzheimer’s disease: a collaborative re-analysis of case-control studies. EURODEM Risk Factors Research Group. The International Journal of Epidemiology, 20 (Suppl 2), S28–S35.Google Scholar
  161. Moss, S., Emerson, E., Kiernan, C., Turner, S., Hatton, C., & Alborz, A. (2000). Psychiatric symptoms in adults with learning disability and challenging behaviour. The British Journal of Psychiatry, 177(5), 452–456.CrossRefPubMedGoogle Scholar
  162. Mukamal, K. J., Kuller, L. H., Fitzpatrick, A. L., Longstreth, W. T., Jr., Mittleman, M. A., & Siscovick, D. S. (2003). Prospective study of alcohol consumption and risk of dementia in older adults. JAMA, 289(11), 1405–1413.CrossRefPubMedGoogle Scholar
  163. Muratore, A. M., Earl, J. K., & Collins, C. G. (2014). Understanding heterogeneity in adaptation to retirement: a growth mixture modeling approach. International Journal of Aging and Human Development, 79(2), 131–156.CrossRefPubMedGoogle Scholar
  164. Myles, P., Leslie, K., Silbert, B., Paech, M., & Peyton, P. (2004). A review of the risks and benefits of nitrous oxide in current anaesthetic practice. Anaesthesia and Intensive Care, 32(2), 165.PubMedGoogle Scholar
  165. Nelson, T. F., & Wechsler, H. (2001). Alcohol and college athletes. Medicine and Science in Sports and Exercise, 33(1), 43–47.CrossRefPubMedGoogle Scholar
  166. Neuman, K. (2008). Quit your job and get healthier? The effect of retirement on health. Journal of Labor Research, 29(2), 177–201.CrossRefGoogle Scholar
  167. Ninomiya, K. (2015). How long is the average career of an NFL player?, from
  168. Nordberg, A., Larsson, C., Perdahl, E., & Winblad, B. (1983). Changes in cholinergic activity in human hippocampus following chronic alcohol abuse. Pharmacology Biochemistry and Behavior, 18, 397–400.CrossRefGoogle Scholar
  169. Nordstrom, P., Michaelsson, K., Gustafson, Y., & Nordstrom, A. (2014). Traumatic brain injury and young onset dementia: a nationwide cohort study. Annals of Neurology, 75(3), 374–381.CrossRefPubMedGoogle Scholar
  170. O’Keefe, M. (2015). Study finds 96 percent of former NFL players had CTE. Retrieved January 7, 2016, from
  171. Ogilvie, B. C., & Howe, M. (1986). The trauma of termination from athletics. Applied Sport Psychology: Personal Growth to Peak Performance, 365382.Google Scholar
  172. Omalu, B. I., DeKosky, S. T., Minster, R. L., Kamboh, M. I., Hamilton, R. L., & Wecht, C. H. (2005). Chronic traumatic encephalopathy in a National Football League player. Neurosurgery, 57(1), 128–134. discussion 128–134.CrossRefPubMedGoogle Scholar
  173. Omalu, B. I., DeKosky, S. T., Hamilton, R. L., Minster, R. L., Kamboh, M. I., Shakir, A. M., & Wecht, C. H. (2006). Chronic traumatic encephalopathy in a national football league player: part II. Neurosurgery, 59(5), 1086–1092. doi: 10.1227/01.NEU.0000245601.69451.27. discussion 1092–1083.PubMedGoogle Scholar
  174. Omalu, B. I., Hamilton, R. L., Kamboh, M. I., DeKosky, S. T., & Bailes, J. (2010). Chronic traumatic encephalopathy (CTE) in a National Football League Player: case report and emerging medicolegal practice questions. Journal of Forensic Nursing, 6(1), 40–46. doi: 10.1111/j.1939-3938.2009.01064.x. JFN1064 [pii].CrossRefPubMedGoogle Scholar
  175. Omalu, B., Bailes, J., Hamilton, R. L., Kamboh, M. I., Hammers, J., Case, M., & Robert Fitzsimmons, J. (2011). Emerging histomorphologic phenotypes of chronic traumatic encephalopathy in American athletes. Neurosurgery, 69(1), 173–183.CrossRefPubMedGoogle Scholar
  176. Pastor, P. N., & Reuben, C. A. (2008). Diagnosed attention deficit hyperactivity disorder and learning disability: United States, 2004–2006. Vital and Health Statistics. Series 10, Data from the National Health Survey (237), 1–14.Google Scholar
  177. Petrovitch, H., White, L. R., Ross, G. W., Steinhorn, S. C., Li, C. Y., Masaki, K. H.,…Markesbery, W. R. (2001). Accuracy of clinical criteria for AD in the Honolulu-Asia Aging Study, a population-based study. Neurology, 57(2), 226–234.Google Scholar
  178. Pihl, R. O., & Peterson, J. (1995). Drugs and aggression: correlations, crime and human manipulative studies and some proposed mechanisms. Journal of Psychiatry and Neuroscience, 20(2), 141–149.PubMedPubMedCentralGoogle Scholar
  179. Ponsford, J., Tweedly, L., & Taffe, J. (2013). The relationship between alcohol and cognitive functioning following traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 35(1), 103–112. doi: 10.1080/13803395.2012.752437.CrossRefPubMedGoogle Scholar
  180. Pope, H. G., & Katz, D. L. (1994). Psychiatric and medical effects of anabolic-androgenic steroid use: a controlled study of 160 athletes. Archives of General Psychiatry, 51(5), 375–382.CrossRefPubMedGoogle Scholar
  181. Porter, V. R., Buxton, W. G., & Avidan, A. Y. (2015). Sleep, cognition and dementia. Current Psychiatry Reports, 17(12), 97. doi: 10.1007/s11920-015-0631-8.CrossRefPubMedGoogle Scholar
  182. Pratico, C., Quattrone, D., Lucanto, T., Amato, A., Penna, O., Roscitano, C., & Fodale, V. (2005). Drugs of anesthesia acting on central cholinergic system may cause post-operative cognitive dysfunction and delirium. Medical Hypotheses, 65(5), 972–982.CrossRefPubMedGoogle Scholar
  183. Putukian, M., Kreher, J. B., Coppel, D. B., Glazer, J. L., McKeag, D. B., & White, R. D. (2011). Attention deficit hyperactivity disorder and the athlete: an American Medical Society for Sports Medicine position statement. Clinical Journal of Sport Medicine, 21(5), 392–401. doi: 10.1097/JSM.0b013e3182262eb1.CrossRefPubMedGoogle Scholar
  184. Quinn, P. O. (2005). Treating adolescent girls and women with ADHD: gender‐specific issues. Journal of Clinical Psychology, 61(5), 579–587.CrossRefPubMedGoogle Scholar
  185. Randolph, C. (2014). Is chronic traumatic encephalopathy a real diseaes? Current Sports Medicine Reports, 13(1), 33–37.PubMedGoogle Scholar
  186. Reams, N., Eckner, J.T., Ameida, A.A., Aagesen, A.L., Giordani, B., Paulson, H., …Kutcher, J.S. (2016). A clinical approach to the diagnosis of traumatic encephalopathy syndrome: a review. JAMA Neurology, 73(6), 743–749. doi: 10.1001/jamaneurol.2015.5015.
  187. Rechel, J., Collins, C., & Comstock, D. (2010). Epidemiology of injuries requiring surgery among US high school athletes. Injury Prevention, 16(Suppl 1), A254.CrossRefGoogle Scholar
  188. Ren, Z., Iliff, J. J., Yang, L., Yang, J., Chen, X., Chen, M. J., ... & Nedergaard, M. (2013). ‘Hit & Run’ model of closed-skull traumatic brain injury (TBI) reveals complex patterns of post-traumatic AQP4 dysregulation. Journal of Cerebral Blood Flow & Metabolism, 33(6), 834-845. doi: 10.1038/jcbfm.2013.30
  189. Riemann, D., Berger, M., & Voderholzer, U. (2001). Sleep and depression--results from psychobiological studies: an overview. Biological Psychology, 57(1–3), 67–103.CrossRefPubMedGoogle Scholar
  190. Riffkin, R. (2014). Average U.S. Retirement Age Rises to 62. from
  191. Sagoe, D., Molde, H., Andreassen, C. S., Torsheim, T., & Pallesen, S. (2014). The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Annals of Epidemiology, 24(5), 383–398. doi: 10.1016/j.annepidem.2014.01.009.CrossRefPubMedGoogle Scholar
  192. Sambataro, F., Murty, V. P., Callicott, J. H., Tan, H.-Y., Das, S., Weinberger, D. R., & Mattay, V. S. (2010). Age-related alterations in default mode network: impact on working memory performance. Neurobiology of Aging, 31(5), 839–852. doi: 10.1016/j.neurobiolaging.2008.05.022.CrossRefPubMedGoogle Scholar
  193. SAMHSA. (2009). Mental Health Services Administration (2009) Results from the 2008 national survey on drug use and health: national findings (Office of Applied Studies, NSDUH Series H-36, HHS Publication No. SMA 09–4434). Rockville, MD.Google Scholar
  194. SAMHSA. (2013). National Survey on Drug Use and Health (NSDUH). Table 2.46B—Alcohol Use, Binge Alcohol Use, and Heavy Alcohol Use in the Past Month among Persons Aged 18 or Older, by Demographic Characteristics: Percentages, 2012 and 2013.Google Scholar
  195. Savica, R., Parisi, J. E., Wold, L. E., Josephs, K. A., & Ahlskog, J. E. (2012). High school football and risk of neurodegeneration: a community-based study. Mayo Clinic Proceedings, 87(4), 335–340. doi: 10.1016/j.mayocp.2011.12.016.CrossRefPubMedPubMedCentralGoogle Scholar
  196. Schwenk, T. L., Gorenflo, D. W., Dopp, R. R., & Hipple, E. (2007). Depression and pain in retired professional football players. Medicine and Science in Sports and Exercise, 39(4), 599–605.CrossRefPubMedGoogle Scholar
  197. Seitz, D. P., Reimer, C. L., & Siddiqui, N. (2013). A review of epidemiological evidence for general anesthesia as a risk factor for Alzheimer’s disease. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 47, 122–127.CrossRefPubMedGoogle Scholar
  198. Shifrer, D., Muller, C., & Callahan, R. (2011). Disproportionality and learning disabilities: parsing apart race, socioeconomic status, and language. Journal of Learning Disabilities, 44(3), 246–257.CrossRefPubMedGoogle Scholar
  199. Shih, C. L., Chi, S. I., Chiu, T. H., Sun, G. Y., & Lin, T. N. (2001). Ethanol effects on nitric oxide production in cerebral pial cultures. Alcoholism: Clinical and Experimental Research, 25(4), 612–618.CrossRefGoogle Scholar
  200. Solomon, G. S., Kuhn, A. W., Zuckerman, S. L., Casson, I. R., Viano, D. C., Lovell, M. R., & Sills, A. K. (2016). Participation in pre-high school football and neurological, neuroradiological, and neuropsychological findings in later life: a study of 45 retired national football league players. The American Journal of Sports Medicine, OnlineFirst. doi: 10.1177/0362546515626164.Google Scholar
  201. Spencer, N., Bambang, S., Logan, S., & Gill, L. (1999). Socioeconomic status and birth weight: comparison of an area-based measure with the Registrar General’s social class. Journal of Epidemiology and Community Health, 53(8), 495–498.CrossRefPubMedPubMedCentralGoogle Scholar
  202. Sprung, J., Jankowski, C. J., Roberts, R. O., Weingarten, T. N., Aguilar, A. L., Runkle, K. J.,…Hanson, A. C. (2013). Anesthesia and incident dementia: a population-based, nested, case-control study. Paper presented at the Mayo Clinic Proceedings.Google Scholar
  203. Stamm, J. M., Bourlas, A. P., Baugh, C. M., Fritts, N. G., Daneshvar, D. H., Martin, B. M.,…Stern, R. A. (2015). Age of first exposure to football and later-life cognitive impairment in former NFL players. Neurology, 84(11), 1114–1120. doi: 10.1212/WNL.0000000000001358.
  204. Stepanski, E. J., & Wyatt, J. K. (2003). Use of sleep hygiene in the treatment of insomnia. Sleep Medicine Reviews, 7(3), 215–225.CrossRefPubMedGoogle Scholar
  205. Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8(03), 448–460.CrossRefPubMedGoogle Scholar
  206. Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47(10), 2015–2028. doi: 10.1016/j.neuropsychologia.2009.03.004.CrossRefPubMedPubMedCentralGoogle Scholar
  207. Stern, R. A., Daneshvar, D. H., Baugh, C. M., Seichepine, D. R., Montenigro, P. H., Riley, D. O.,…McHale, L. (2013). Clinical presentation of chronic traumatic encephalopathy. Neurology, 81(13), 1122–1129.Google Scholar
  208. Strain, J. F., Womack, K. B., Didehbani, N., Spence, J. S., Conover, H., Hart, J., Jr.,…Cullum, C. M. (2015). Imaging correlates of memory and concussion history in retired national football league athletes. JAMA Neurology, 72(7), 773–780. doi: 10.1001/jamaneurol.2015.0206.
  209. Stringaris, A., Psych, M., Cohen, P., Pine, D. S., & Leibenluft, E. (2009). Adult outcomes of youth irritability: a 20-year prospective community-based study. The American Journal of Psychiatry, 166(9), 1048–1054.CrossRefPubMedPubMedCentralGoogle Scholar
  210. Sullan, M. J., Bohsali, A. A., Gullett, J. M., Goldstein, J., Bauer, R. M., Mareci, T. H., & FitzGerald, D. B. (2014). The locus coeruleus and sleep-wake disturbances in veterans with mTBI. Journal of Sleep Medicine and Disorders.Google Scholar
  211. Svoboda, B., & Vanek, M. (1982). Retirement from high level competition. In Proceedings of the 5th world congress of sport psychology (pp. 166–175). Ottawa, ON: Coaching Association of Canada.Google Scholar
  212. Tabuchi, M., Lone, S. R., Liu, S., Liu, Q., Zhang, J., Spira, A. P., & Wu, M. N. (2015). Sleep interacts with abeta to modulate intrinsic neuronal excitability. Current Biology, 25(6), 702–712. doi: 10.1016/j.cub.2015.01.016.CrossRefPubMedPubMedCentralGoogle Scholar
  213. Taylor, D. J., & Pruiksma, K. E. (2014). Cognitive and behavioural therapy for insomnia (CBT-I) in psychiatric populations: a systematic review. International Review of Psychiatry, 26(2), 205–213.CrossRefPubMedGoogle Scholar
  214. The Institute for Diversity and Ethics in Sport. (2015). from
  215. The National Football League Race and Gender Report Card. (2015). The institute for diversity and ethics in sport. from
  216. Thomas, V. S., & Rockwood, K. J. (2001). Alcohol abuse, cognitive impairment, and mortality among older people. Journal of the American Geriatrics Society, 49(4), 415–420.CrossRefPubMedGoogle Scholar
  217. Torre, P. (2009). How (and Why) Athletes Go Broke. from
  218. Tremblay, S., De Beaumont, L., Henry, L. C., Boulanger, Y., Evans, A. C., Bourgouin, P.,…Lassonde, M. (2013). Sports concussions and aging: a neuroimaging investigation. Cereb Cortex, 23(5), 1159–1166. doi: 10.1093/cercor/bhs102.
  219. Tremblay, S., Henry, L. C., Bedetti, C., Larson-Dupuis, C., Gagnon, J. F., Evans, A. C.,…De Beaumont, L. (2014). Diffuse white matter tract abnormalities in clinically normal ageing retired athletes with a history of sports-related concussions. Brain, 137(Pt 11), 2997–3011. doi: 10.1093/brain/awu236.
  220. Trief, P. M., Grant, W., & Fredrickson, B. (2000). A prospective study of psychological predictors of lumbar surgery outcome. Spine, 25(20), 2616–2621.CrossRefPubMedGoogle Scholar
  221. Tsuno, N., Besset, A., & Ritchie, K. (2005). Sleep and depression. Journal of Clinical Psychiatry.Google Scholar
  222. Tully, P. J., Baker, R. A., & Knight, J. L. (2008). Anxiety and depression as risk factors for mortality after coronary artery bypass surgery. Journal of Psychosomatic Research, 64(3), 285–290.CrossRefPubMedGoogle Scholar
  223. Turrell, G., Lynch, J. W., Kaplan, G. A., Everson, S. A., Helkala, E.-L., Kauhanen, J., & Salonen, J. T. (2002a). Socioeconomic position across the lifecourse and cognitive function in late middle age. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57(1), S43–S51.CrossRefGoogle Scholar
  224. Van Meter, A., Youngstrom, E., Freeman, A., Feeny, N., Youngstron, J. K., & Findling, R. L. (2016). Impact of irritability and impulsive aggressive behavior on impairment and social functioning in youth with cyclothymic disorder. Journal of Child and Adolescent Psychopharmacology, 26(1), 26–37. doi: 10.1089/cap.2015.0111.CrossRefPubMedGoogle Scholar
  225. Vance, D. E., & Crowe, M. (2006). A proposed model of neuroplasticity and cognitive reserve in older adults. Activities, Adaptation, & Aging, 30(3), 61–79.CrossRefGoogle Scholar
  226. Victoroff, J. (2012). Traumatic encephalopathy: review and provisional research diagnostic criteria. NeuroRehabilitation, 32(2), 211–224.Google Scholar
  227. Wagner, U., & Born, J. (2008). Memory consolidation during sleep: Interactive effects of sleep stages and HPA regulation: Review. Stress, 11(1), 28–41.CrossRefPubMedGoogle Scholar
  228. Waljas, M., Iverson, G. L., Lange, R. T., Hakulinen, U., Dastidar, P., Huhtala, H.,…Ohman, J. (2015). A prospective biopsychosocial study of the persistent post-concussion symptoms following mild traumatic brain injury. Journal of Neurotrauma. doi: 10.1089/neu.2014.3339.
  229. Wang, M., & Shi, J. Q. (2014). Psychological research on retirement. Annual Review of Psychology, 65(65), 209–233. doi: 10.1146/annurev-psych-010213-115131.CrossRefPubMedGoogle Scholar
  230. Warner, D. C., Schnepf, G., Barrett, M. S., Dian, D., & Swigonski, N. L. (2002). Prevalence, attitudes, and behaviors related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in student athletes. Journal of Adolescent Health, 30(3), 150–153.CrossRefPubMedGoogle Scholar
  231. Webster, L. R., Choi, Y., Desai, H., Webster, L., & Grant, B. J. (2008). Sleep‐disordered breathing and chronic opioid therapy. Pain Medicine, 9(4), 425–432.CrossRefPubMedGoogle Scholar
  232. Wei, H., Liang, G., Yang, H., Wang, Q., Hawkins, B., Madesh, M.,…Eckenhoff, R. G. (2008). The common inhalational anesthetic isoflurane induces apoptosis via activation of inositol 1,4,5-trisphosphate receptors. Anesthesiology, 108(2), 251–260. doi: 10.1097/01.anes.0000299435.59242.0e.
  233. Weir, D. R., Jackson, J. S., & Sonnega, A. (2009). National football league player care foundation study of retired NFL players. Ann Arbor: University of Michigan Institute for Social Research.Google Scholar
  234. Werthner, P., & Orlick, T. (1986). Retirement experiences of successful Olympic athletes. International Journal of Sport Psychology. Google Scholar
  235. White, R. D., Harris, G. D., & Gibson, M. E. (2014). Attention deficit hyperactivity disorder and athletes. Sports Health: A Multidisciplinary Approach, 6(2), 149–156.CrossRefGoogle Scholar
  236. Whittington, R. A., Bretteville, A., Dickler, M. F., & Planel, E. (2013). Anesthesia and tau pathology. Progress in Neuropsychopharmacology and Biological Psychiatry, 47, 147–155. doi: 10.1016/pnpbp.2013.03.004.CrossRefGoogle Scholar
  237. Wickrama, K. K., & O’Neal, C. W. (2013). The influence of working later in life on memory functioning. Advances in Life Course Research, 18(4), 288–295. doi: 10.1016/j.alcr.2013.09.001.CrossRefPubMedGoogle Scholar
  238. Wilson, R. S., Scherr, P. A., Hoganson, G., Bienias, J. L., Evans, D. A., & Bennett, D. A. (2005). Early life socioeconomic status and later life risk of Alzheimer’s disease. Neuroepidemiology, 25(1), 8–14. doi: 10.1159/000085307.CrossRefPubMedGoogle Scholar
  239. Wolkove, N., Elkholy, O., Baltzan, M., & Palayew, M. (2007). Sleep and aging: 1. Sleep disorders commonly found in older people. CMAJ, 176(9), 1299–1304. doi: 10.1503/cmaj.060792.CrossRefPubMedPubMedCentralGoogle Scholar
  240. Wylleman, P., & Lavallee, D. (2004). A developmental perspective on transitions faced by athletes. Developmental sport and exercise psychology: A lifespan perspective, 507–527.Google Scholar
  241. Xie, L., Kang, H., Xu, Q., Chen, M. J., Liao, Y., Thiyagarajan, M.,…Nedergaard, M. (2013). Sleep drives metabolite clearance from the adult brain. Science, 342(6156), 373–377. doi: 10.1126/science.1241224.
  242. Yaffe, K., Laffan, A. M., Harrison, S. L., Redline, S., Spira, A. P., Ensrud, K. E.,…Stone, K. L. (2011). Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA, 306(6), 613–619.Google Scholar
  243. Yesalis, C. E., & Bahrke, M. S. (1995). Anabolic-androgenic steroids. Current issues. Sports Medicine, 19(5), 326–340.CrossRefPubMedGoogle Scholar
  244. Zuckerman, S. L., Lee, Y. M., Odom, M. J., Solomon, G. S., & Sills, A. K. (2013). Baseline neurocognitive scores in athletes with attention deficit-spectrum disorders and/or learning disability. Journal of Neurosurgery Pediatrics, 12(2), 103–109. doi: 10.3171/2013.5.PEDS12524.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Breton M. Asken
    • 1
    Email author
  • Molly J. Sullan
    • 1
  • Aliyah R. Snyder
    • 1
  • Zachary M. Houck
    • 1
  • Vaughn E. Bryant
    • 1
  • Loren P. Hizel
    • 1
  • Molly E. McLaren
    • 1
  • Duane E. Dede
    • 1
  • Michael S. Jaffee
    • 2
  • Steven T. DeKosky
    • 2
  • Russell M. Bauer
    • 1
  1. 1.Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleUSA
  2. 2.Department of NeurologyUniversity of FloridaGainesvilleUSA

Personalised recommendations