Neither American Football Playing Position Nor Total Years Playing Football Are Associated with Neurobehavioral Health Outcomes: An NFL-LONG Study

Abstract

Years playing American football and primary playing position are often used to estimate concussion exposure. We examined associations between playing position and total years played with concussion history and neurobehavioral outcomes among former (N = 1544) National Football League players in the NFL-LONG study. Outcomes included the PROMIS Cognitive, Depression, and Anxiety T-scores, and Neuro-QOL Emotional-Behavioral Dyscontrol T-scores. Playing position was categorized as offensive/defensive linemen, running back/linebacker/tight end, quarterback/wide receiver/defensive back, and special teams. Analysis of variance tested differences between years played across position groups. Multivariable regressions estimated associations between years played, position group, and their interaction for outcomes, adjusting for covariates. There was no significant difference in years played across playing positions, and no statistically or clinically significant findings linking position, years played, or their interaction with negative neurobehavioral outcomes. These findings suggest concussion history should be directly assessed and considered alongside other exposure indicators to better understand neurobehavioral outcomes.