Aims:
Traumatic brain injuries (TBI), including concussions, are risk factors for cognitive and behavioural impairment in aging populations. This study examines the effects of sports-related (SRC) and non-sports-related concussions (nSRC) on cognitive and behavioural outcomes in adults over 65 years.
Methods:
Data were obtained from the PROTECT Study and cognitive outcomes were measured using the PROTECT Cognitive Test Battery and COGTRACK. Behavioural outcomes were assessed using the Mild Behavioural Impairment Checklist (MBI-C). Principal component analysis grouped cognitive tests into domains. Negative binomial regression models examined behavioural outcomes, adjusting for covariates. Participants were categorized by SRC and nSRC history. Sensitivity analyses ensured robustness. Multiple imputation addressed missing data, with significance set at p<0.01.
Results:
nSRCs were linked to deficits in attention (B=-0.156, p=0.001) and processing speed (B=-0.082, p=0.010), increased MBI-C scores (Estimate=-0.299, p<0.001). Multiple nSRCs worsened these effects, 3+ nSRCs associated with verbal reasoning decline (B=-0.088, p=0.005). SRC showed no cognitive deficits; one SRC was linked to better verbal reasoning (B=0.111, p=0.006) and attention (B=0.115, p=0.010). SRC’s protective effects in younger cohorts were absent though. Females had worse working memory (B=-0.084, p<0.001) and higher MBI-C scores (Estimate=-0.554, p<0.001). Higher education was protective.
Conclusions:
nSRC are strongly associated with cognitive and behavioural declines, increasing vulnerability to neurodegenerative conditions. While SRC did not show long-term cognitive deficits, its protective effects were absent in older adults. This highlights the importance of concussion history in geriatric assessments and tailored interventions to mitigate cognitive deterioration in older individuals with a history of nSRC.