American football is a high-octane contact sport in which repetitive head impacts (RHI) are a common sight. Researchers investigated the link between playing football and brain health, memory, and mental well-being later in life.
A football player races down the field at full speed, ready to pass the ball to his teammate, when suddenly, a heavily built opponent weighing more than 200 pounds barrels in at high velocity. The crash happens in an instant, yet the impact absorbed in that brief moment can linger, revealing its consequences long after they have retired from the sport.
In the new cross-sectional study, researchers analyzed data from 3,970 former male American football players aged 40 or older. The group included men who had played at all levels, ranging from youth and high school teams to the professional ranks.
Participants completed a series of tests designed to assess brain function, memory, and symptoms of depression. The test results were then compared with a control. The findings are published in the journal JAMA Network Open.
It was found that former players performed significantly worse on memory/thinking tests, reported greater concerns about their cognitive abilities, and experienced higher levels of depressive symptoms compared with those with no history of RHI. The more exposure a person had to football, the worse their outcomes tended to be.
Hidden impact of contact
In the United States, football alone accounts for roughly 300,000 concussions each year. The risk, however, does not end with diagnosed concussions. Even blows to the head that cause no obvious symptoms and do not meet the criteria for a concussion can still injure the brain.
These repeated, lower-level impacts—known as subconcussive hits—are drawing increasing concern among researchers, who warn that over time they may threaten long-term brain health and contribute to chronic traumatic encephalopathy (CTE).
Most previous studies on these risks focused almost entirely on small groups of elite or professional players, limiting our understanding of how football exposure affects the broader population.
As a result, the findings could not be easily generalized to the millions of men who played only at the youth, high school, or collegiate levels. Many of these studies also lacked appropriate control groups, making it harder to draw clear conclusions about whether the cognitive and mental health insights were from the impact of playing football alone or whether there were other factors involved.
In this study, the researchers not only recruited a larger cohort of former football players for the primary study, which was testing later-life cognitive and neuropsychiatric function, but also compared the scores of 661 former football players to a demographically matched control group of 282 men who had no history of RHI.
The analysis revealed that professional players scored the lowest on the tests and had the highest likelihood of cognitive and psychiatric impairment. The findings also pointed to a dose-response relationship, where a longer exposure to football was linked to progressively worse outcomes.
The researchers believe these insights offer valuable context to help clinicians and researchers better assess the risk of symptoms in former players.
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Publication details
Anna Aaronson et al, Cognitive and Neuropsychiatric Function in Former American Football Players, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2025.60077
Journal information:
JAMA Network Open
Key medical concepts
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